Low Production Research Articles

France, Economic Liberalism, and the Populist Challenge

Abstract This article reviews Contested Liberalization by Jonah Levy. Levy explores the role of politics in slowing the implementation of neoliberal economic policies in France, from the 1980s forward. Levy devotes special attention to the politics and policies of Emmanual Macron. The article examines Levy's argument in the context of the French “dirigiste” tradition and considers Macron's policies and the recent rise of populism in France. It argues that populism has arisen in many advanced countries as they have shifted from industrial to service economies. The rise in working class grievance in the face of low productivity and wage stagnation has proved fertile ground for populist parties.

Intensified microalgae production and development of microbial communities on suspended carriers and municipal wastewater

Wastewater represents an alternative source of nutrients in which to grow microalgae, whilst improving the quality of the wastewater, and reducing the downstream treatment required. However, commercialisation of microalgal cultures for such duties faces a number of challenges, predominantly high cost and low productivity. Suspended-solid reactors (ssPBR) can reduce the operational costs, while promoting attached and suspended microalgae growth. In the present study, a novel approach was developed by integrating microalgal wastewater treatment with carrier systems to favour the growth of both attached and suspended cells of T. obliquus. This study found that T. obliquus was able to uptake nutrients from municipal wastewater, achieving removals of 99.3–99.9 % NH3-N, 54.5–88.5 % PO43− and 92.8–94.5 % DTC. The addition of a 12.5 % volumetric fill ratio of carriers in ssPBRs produced higher microalgal cell productivity (1.2·106 ± 2.5·105 cell ml−1 d−1) than the control (4.3·105 ± 2.8·105 cell ml−1 d−1). MinION nanopore sequencing was conducted to assess the impact of microalgal and carrier treatment on wastewater bacterial communities. It was found not only that bacterial communities had changed after the treatment but also the ones attached differed from the ones suspended. Untreated wastewater was characterised by the abundance of sewer bacteria genera such as Aliarcobacter and Arcobacter, whilst, after treatment, microbial communities were characterised by the presence of photosynthetic freshwater (Limnococcus, Stanieria) and bioremediation-like bacteria genera (Pseudomonas, Rheinheimera). In conclusion, the addition of 12.5 % fill carrier ratio increased microalgal productivity, while stimulating changes in the algal microbiome, and creating distinctly different populations in the free and attached environments.

Preliminary outcomes on phenotypic and genetic parameter estimates for body weight of indigenous Tswana goats in Botswana

The aims of this study were to estimate the genetic and phenotypic parameters for growth traits and evaluate genetic trends on 585 indigenous Tswana goats. The population was maintained under low input production system at the Department of Agricultural Research in Lesego ranch, Botswana, from 2005 to 2008. Data included birth weight (BW), weaning weight (WW), weight at 8 months (PW), yearling weight (YW), pre-weaning average daily gain (ADG) and two post weaning average daily gains (ADG2 and ADGYW). Data was analysed using general linear model of SAS to determine non-genetic effects. Estimation of genetic and phenotypic parameters were estimated using ASREML fitting an animal model that accounted for fixed effect of parity, sex, type of birth and year of birth. Least squares means for BW, WW, PW and YW were 2.88 ± 0.03, 12.15 ± 0.17, 16.52 ± 0.28 and 21.04 ± 0.32Kg, respectively, while those for ADG, ADG2 and ADGYW were 74.52 ± 1.41, 28.78 ± 1.55 and 33.66 ± 2.28 g/day, respectively. Estimates of heritability for BW, WW, PW and YW were 0.79 ± 0.11, 0.63 ± 0.14, 0.32 ± 0.13 and 0.48 ± 0.16, respectively. The genetic correlations for all the traits studied were positive and moderate to high (0.48 to 0.82) whilst phenotypic correlations ranged from 0.21 to 0.72. Positive average genetic trends of 12.32% (WW), 13.39% (PW) and 7.38% (YW) were attained. The results have demonstrated the potential of this breed to be improved through selection.

Optimization of Low-Pressure Turbine Blade by Means of Fine Inspection of Loss Production Mechanisms

Abstract In this study, Proper Orthogonal Decomposition (POD) was applied to Large Eddy Simulations (LES) of two high-loaded low-pressure turbine cascades under unsteady inflow conditions to investigate entropy production within different parts of the blade passage. The terms for Turbulent Kinetic Energy (TKE) production, diffusion, and dissipation from the stagnation pressure transport equation were integrated across the computational domain. The POD-based method enables the decomposition of contributions from various coherent flow dynamics to TKE production and dissipation, such as the migration, bowing, tilting, and reorientation of incoming wake filaments, as well as the breakdown of streaky structures in the blade boundary layer and the formation of Von Karman vortices in the blade wake. This approach helps designers identify the dominant POD modes (i.e., turbulent flow structures) responsible for loss generation, understand their dynamics and locate where they primarily act. Using this optimization strategy, a new low-pressure turbine profile was designed. LES calculations on the optimized geometry showed that it is possible to design a higher-loaded profile with a lower global loss coefficient. The new loading distribution, characterized by stronger acceleration in the early part of the blade passage, results in reduced upstream wake migration losses and lower TKE production in the trailing edge wake zone due to early suction side boundary layer transition.

Optimization and modelling of bioethanol production by the fermentation of CCN‐51 cocoa mucilage using the sequential simplex method and the modified Gompertz model

AbstractThis work deals with the optimization of bioethanol production through a fermentation process of CCN‐51 cocoa mucilage, based on increased concentrations of the Saccharomyces cerevisiae yeast. Cocoa mucilage, considered biomass waste, was selected for its high productivity and the large volumes generated in the cocoa industrial chain in Ecuador. The optimization of the fermentation process was performed using the sequential simplex method with two variables, and the results were experimentally confirmed by quantifying bioethanol through the microdiffusion method. The best operational conditions corresponded to a temperature of 35°C and a pH of 4. Regarding the concentration of yeast, it was found that the optimal value was 8 g/L, since lower concentrations led to low productivities, while higher concentrations resulted in inadequate functioning of the bioreactor. The best results reached a productivity of 1.35 ± 0.04 g/L · h and a maximum bioethanol concentration of 28.3 ± 0.8 g/L for a processing time of 21 h. The production of bioethanol was modelled using the modified Gompertz equation and simulated in MATLAB®, yielding a bioethanol production rate of 2.42 g/L · h with a correlation coefficient (R2) of 0.95. These results contribute to the knowledge of bioethanol production using cocoa mucilage and seek to add a positive value to this residue, whose management and final disposition have both undesirable environmental and economic effects.

Basalt Fiber Reinforced Polymers: A Recent Approach to Electromagnetic Interference (EMI) Shielding

ABSTRACTElectromagnetic wave (EMW) radiation pollution is getting more severe as result of the advancement of electronic technology. Researching shielding materials with superior EMI (electromagnetic interference) shielding characteristics is therefore crucial. Basalt fibers (BFs) have been an emerging candidate in the fiber‐reinforced polymer (FRP) category due to their favorable mechanical and chemical properties, along with being favorites in sustainability and having low production costs. Therefore, due to the rising need for cheaper and efficient alternatives in the EMI shielding industry, the EMI shielding is covered in terms of BF composite materials and their properties in this review, starting with the EMI shielding mechanism and followed by how BF composites affect the EMI properties. This review then covers the post‐treatments of BF composites and, finally, the factors of the composites that affect the EMI properties. Moreover, the EMI shielding applications in which BFRPs are used are comprehensively discussed as well. This review aspires to bridge an understanding between EMI shielding as a material property and the BF composites that are developed to aid in the EMI shielding application.

Copper nanoparticles biosynthesis by Priestia megaterium and its application as antibacterial and antitumor agents

The growth of material science and technology places high importance on creating better processes for synthesizing copper nanoparticles. Thus, an easy, ecological, and benign process for producing copper nanoparticles (CuNPs) has been developed using Priestia sp. bacteria utilizing a variety of low-cost agro-industrial wastes and byproducts. The biosynthesis of CuNPs was conducted using glucose medium and copper ions salt solution, then it was replaced by utilizing low-cost agro-industrial wastes. UV–visible spectroscopy, dynamic light scattering (DLS), X-ray diffraction (XRD), High-resolution transmission electron microscope (HR-TEM), Attenuated Total Reflectance and Fourier transform infrared (ATR-FTIR), and zeta potential were used to characterize the biosynthesized CuNPs. The cytotoxicity of CuNPs using Vero -CCL-81 cell lines, and antibacterial and antitumor properties using human colon epithelial colorectal adenocarcinoma Caco-2-HTB-37 cell lines were assessed. The UV–visible and DLS studies revealed CuNPs formation, with a maximum concentration of 6.19 ppm after 48 h, as indicated by a 0.58 Surface plasmon resonance (SPR) within 450 nm and 57.73 nm particle size. The 16S rRNA gene analysis revealed that Priestia sp. isolate is closely related to Priestia megaterium and has been deposited in the NCBI GenBank with accession number AMD 2024. The biosynthesis with various agro-industrial wastes indicated blackstrap sugar cane molasses being the most effective for reducing CuNPs size to 3.12 nm owing to various reducing and stabilizing active compounds. The CuNPs were free of contaminants, with a sphere-shaped structure and a cytotoxicity assessment with an IC50 of 367.27 μg/mL. The antibacterial activity exhibited by the most susceptible bacteria were Bacillus cereus ATCC 11788 and Staphylococcus aureus ATCC 6538 with inhibition zones of 26.0 mm and 28.0 mm, respectively. The antitumor effect showed an IC50 dose of 175.36 μg/mL. Based on the findings, the current work sought to lower product costs and provide a practical solution to the environmental contamination issues brought on by the buildup of agricultural wastes. In addition, the obtained CuNPs could be applied in many fields such as pharmaceuticals, water purification, and agricultural applications as future aspects.

The potential role of iron-carbon micro-electrolysis materials in curtailing lag-phase stimulates kitchen waste anaerobic digestion at different solid contents: Performance, synergistic effect and microbial response

High-solid anaerobic digestion (HSAD) of kitchen waste was generally faced to the common problems such as systemic acidification, prolonged lag-phase time and low methane production. Iron-carbon micro-electrolysis (ICME) materials exhibited advantages that porous structure, large specific surface area and excellent conductivity. It was beneficial for organic compounds to hydrolysis. Moreover, ICME materials could establish direct interspecies electron transfer (DIET) pathway between bacteria and methanogens. ICME materials were commonly used to enhance the AD of wastewater, but they were rarely applied to HSAD of kitchen waste. In this study, ICME materials were utilized to enhance HSAD of kitchen waste at different solid content conditions. The results showed that the highest cumulative biogas yield (705.23 mL/g VS) was obtained in the experimental group (TS = 10%), which was 94.15% higher than that of the control group. At the same time, the addiction of ICME could shorten lag-phase time. Electrochemical characteristics and XPS analysis showed that ICME materials promoted the release of Fe2+ in the AD system and acceleration of direct interspecies electron transfer between microorganisms. Microbial community analysis showed that ICME materials enriched electroactive bacteria (Proteiniphilum), Methanosarcina, Methanobrevibacter and Methanofollis. Functional gene prediction revealed that ICME materials increased the relative abundance of carbohydrate transport and metabolism and coenzyme transport and metabolism. It provided a potential measure to treat kitchen waste.

Mechanization in Cotton Farming: Addressing Labor Shortages and Enhancing Productivity in India

Cotton is a globally significant crop, playing a vital role in both the agricultural and industrial economy. Cotton is a crucial raw material for the textile and apparel industries, driving international trade and commerce. Its global demand influences market dynamics, trade policies, and economies worldwide. The cotton industry provides livelihoods for millions of people, particularly in developing countries, from farming to manufacturing, making it a key source of employment globally. In India, approximately 59% of the raw material for India's textile industry comes from cotton. However, cotton cultivation is challenged by lower yields and high costs associated with various operations such as sowing, weed management, pest control, and harvesting. Mechanization significantly improves cotton yield and profitability by enhancing efficiency, reducing labor, and enabling the cultivation of larger areas with better resource utilization. Precision tools like seed-cum-fertilizer drills and mechanized planters ensure optimal seed placement and spacing, boosting plant health and yield potential. Additionally, mechanized harvesting reduces labor costs, minimizes harvest losses, and ensures better-quality cotton, leading to higher market returns and overall profitability. The innovative concept of High Density Planting Systems (HDPS) shows great potential for improving yields, particularly in rainfed cotton. This system involves planting five to ten plants per square meter, which enhances yield and is compatible with mechanized operations for seeding, weeding, pest management, and harvesting. The key objective of using improved sowing equipment is to achieve precise seed distribution within the row, facilitating operations like weeding and fertilizing at predetermined distances and depths. Proper seed placement by planters is critical to achieving optimal germination. Implementing efficient mechanical weeders could motivate small-scale farmers, boosting production and reducing poverty. A power weeder, a mechanized tool commonly used for preparing soil beds, offers significant savings in time, labor, and fuel. Furthermore, the adoption of mechanical cotton pickers would help ensure timely harvesting operations, increasing yields and contributing to higher cotton production. India’s low cotton productivity can be attributed to the limited adoption of modern agronomic practices and the low level of mechanization. Embracing these innovations could lead to significant improvements in the cotton sector Cotton pickers and strippers play a vital role in modern, large-scale cotton cultivation by significantly reducing harvesting time and labor costs, making them indispensable for efficient operations. These machines increase productivity by enabling faster harvesting across larger areas, minimizing the reliance on manual labor, which can be costly and scarce. Additionally, they reduce harvest losses and enhance yield by ensuring more cotton is collected with minimal waste. Cotton pickers, being gentler, help preserve fiber quality, while strippers are ideal for bulk harvesting in regions growing lower-grade cotton. Overall, mechanized harvesting ensures timely and efficient cotton collection, improving both yield and quality.

Preserving refrigeration and shelf life quality of hardy kiwifruit (Actinidia arguta) with alginate oligosaccharides preharvest application.

Alginate oligosaccharide (AOS) is a bioactive carbohydrate known for its preservation properties. However, the efficacy of preharvest AOS treatment in maintaining the postharvest quality of hardy kiwifruit (Actinidia arguta) has not been previously reported. This study explores the effects of preharvest AOS treatment (80mg L-1) on A. arguta fruit, assessing visual quality, physiological attributes, aroma, and antioxidant capacity during refrigeration and shelf life. Results showed that AOS treatment maintained higher lightness, chroma, firmness, and antioxidant levels (total phenolics, flavonoids, ascorbic acid, and glutathione), along with antioxidant enzyme activities (peroxidase, catalase, and ascorbate peroxidase). Specifically, AOS-treated fruit had 9% higher chroma and double the firmness after 60 days of refrigeration. AOS treatment reduced ripening and senescence, with 25% lower soluble solids content, 22% lower respiration rate, 30% lower ethylene production, and 35% lower malondialdehyde content. Electronic nose analysis indicated that AOS treatment suppressed changes in fruit aroma and off-odor development, maintaining significantly higher quality during the shelf life period. These findings demonstrate the effectiveness of AOS as a sustainable method to extend shelf life and preserve the quality of A. arguta fruit, enhancing its market value and consumer appeal. PRACTICAL APPLICATION: The research on using alginate oligosaccharides (AOS) for preharvest treatment of hardy kiwifruit (Actinidia arguta) has practical applications in the food industry. By extending the shelf life and preserving the quality of the fruit during storage, this method can help reduce postharvest losses and improve the market value and consumer appeal of A. arguta fruit. This sustainable preservation technique offers an eco-friendly alternative to traditional methods, enhancing the freshness and nutritional quality of the fruit available to consumers.

Bioprospecting of Metschnikowia pulcherrima Strains, Isolated from a Vineyard Ecosystem, as Novel Starter Cultures for Craft Beer Production

Several studies in recent years have shown that the use of non-Saccharomyces yeasts, used both in single and in mixed fermentations with Saccharomyces cerevisiae, can help produce craft beers with distinctive compositional characteristics. The aim of this study was to evaluate the suitability of three Metschnikowia pulcherrima strains, isolated from Albanian vineyards, for use as starters in the brewing process. Because of its specific enzymatic activities (protease, β-glucosidase, and β-lyase) and its low production of hydrogen sulfide, M. pulcherrima 62 was selected as a starter culture for the production of craft beer. Specifically, the suitability of this yeast for use in sequential inoculation with S. cerevisiae S0-4 for the production of an American IPA-style beer and the main volatile compounds produced during fermentation were evaluated. The results show significant differences in the glycerol, isoamyl alcohol, and isoamyl acetate contents in beer obtained by sequential inoculum of M. pulcherrima 62 with S. cerevisiae S0-4 compared to beer obtained using S. cerevisiae S0-4 as a single starter. Therefore, these preliminary data support the candidacy of M. pulcherrima 62 as a new starter in the brewing process.

Flame‐Retardant Polymer Electrolyte for Sodium‐Ion Batteries

AbstractSodium‐ion batteries present an appealing option for large‐scale energy storage applications due to their high natural abundance and low production costs. However, the safety issue remains a major obstacle in current development, primarily owing to the use of liquid electrolytes (LEs), which can lead to leakage and combustion. To achieve both high energy density and enhanced safety, researchers are increasingly focusing on solid‐state electrolytes (SSEs). Solid‐state polymer electrolytes (SPEs) have garnered notable attention due to their superior mechanical flexibility and electrochemical stability. Nonetheless, traditional SPEs can also undergo combustion and decomposition under extreme conditions due to polymer inherent flammability. Therefore, it is imperative to conduct research and design flame‐retardant SPEs in order to enhance their reliability and safety in practical applications. This review provides a comprehensive overview of the mechanisms underlying battery thermal runaway and offers guidance for designing batteries with enhanced safety. In addition to reviewing recent advancements in flame‐retardant polymer solid‐state sodium battery research, it also presents a systematic classification and introduction of studies on high‐safety polymer electrolytes. Furthermore, it delves into diverse perspectives and approaches towards addressing the issue of safety in polymer sodium battery, ultimately outlining future research directions for this particular field.

Greening Your Drive: A Method of Effective Conversion from IC Engine Based Vehicle to EV

This research presents the most efficient method for turning vehicles with internal combustion engines (IC engines) into electric vehicles (EVs). With an emphasis on reducing the environmental footprint and optimizing energy efficiency, our strategy includes cutting-edge technology in electric powertrain parts, power electronics, and battery storage systems. This paper assesses performance indicators by thoroughly analyzing the integration of new electric drivetrain components and the retrofitting of old ones, including motor starting and energy usage. To produce energy-efficient EVs, we suggest a supercapacitor bank and an effective battery cooling system. The recommended approach, Safety concerns, environmental advantages, and economic viability are also covered. The suggested approach shows promise in terms of lower production of greenhouse gases, increased range, and cost-effectiveness. The results provide an efficient way of battery cooling system and efficient use of battery storage by integrating a supercapacitor bank. The outcomes support the worldwide trend towards environmentally sound methods of transportation by providing important insights that will accelerate the widespread use of sustainable EVs.

Preserving competition and economic welfare in Israel's PV market

Despite global efforts, many countries struggle to meet renewable energy targets. In 2022, Israel's renewable energy accounted for only 10% of its electricity generation despite its abundant solar resources. This study analyzes the outcomes of three tenders for photovoltaic (PV) facilities aimed at advancing national renewable energy goals. The results reveal lower production costs but increased market concentration, with a 50% reduction in the number of winning firms, consolidating around major players. While efficiency has improved, the exit of smaller, less competitive firms raises concerns about long-term dominance. Cournot oligopoly simulations predict rising concentration and market power.

Bacterial Cellulose: A Multifunctional Platform for Biomedical Applications

Bacterial cellulose (BC), a biopolymer synthesized by various bacterial species, has emerged as a promising material for biomedical applications due to its unique properties, including high purity, biocompatibility, mechanical strength, and structural similarity to the extracellular matrix. This review explores the advancements in BC research over the last decade, focusing on its applications in tissue engineering, wound healing, and drug delivery systems. While BC offers numerous benefits, challenges such as large-scale production, structural modification, however regulatory approval hinder its broader clinical use. Recent studies have introduced innovative solutions, such as using agro-industrial waste to lower production costs and combining BC with other materials to enhance its bioactivity. As research progresses, BC has the potential to revolutionize the field of biomedicine, offering sustainable, versatile, and effective solutions for a wide range of medical applications.

How Do Short-Term Incentives Affect Long-Term Productivity?

Abstract Previous research shows that incentives to meet short-term earnings targets can cause firms to increase share buybacks, leading to cuts in investments and employment. Using plant-level census data, we find that incentives to engage in earnings-per-sharemotivated buybacks result in lower productivity at both the plant and firm level. We attribute this productivity drop to two mechanisms: reduced investment in productivityaugmenting technology, and inefficient allocation of resources across a firm’s plants. We identify multiple frictions—including labor unions, financial constraints, agency problems, and adjustment costs—that can constrain efficient reallocations across plants and thus exacerbate the consequences of firms’ short-term incentives. (JEL G32, G35, J23).

6455 The Effect of Gene Silencing on Inhibiting Stress Hormones in Wild Birds Raised Under Stressful Conditions

Abstract Disclosure: S.M. Abdulateef: None. T. Mohammed: None. W. Al-Jugif: None. M.Q. Abed: None. Wild birds are notable for their ease of rearing, tolerance to extreme environmental conditions such as heat and cold, and their resistance to diseases. They are also recognized for their ability to withstand stress. However, their primary challenge is low egg production, stemming from their aggressive nature. This aggression elevates the secretion of stress and fear hormones, significantly impacting reproductive hormones. This study aims to explore the effects of gene silencing on the physiological traits of wild birds, particularly its influence on physiological responses and the reduction of stress hormone levels. Three treatments were employed: T1 (control), T2 (welfare treatment, wherein birds were raised with enhanced well-being), and T3 (using siRNA technology to silence the gene responsible for stress hormone corticosterone production). The silencing of CYP11B1 and CYP11B2 involved obtaining the cDNA of each gene from the NCBI, associated with corticosterone production. The coding sequence from the 5' end at the cap direction was reversed to complement mRNA. Two siRNAs were procured from Macrogene Company (South Korea) in lyophilized form at high concentration, with sequences: CYP11B2 5'-acacctctgcctttgccctgagtgccat-3' and CYP11B1 5'-ctaaagtcaaactcagccccacattcat-3'. These were dissolved in molecular-grade distilled water for a final concentration of 500 pmol/µl. Each hen was injected in the wing in the jugular artery with 125 µl of the siRNA solution at 14 and 18 weeks of age, before the commencement of the egg-laying cycle. Corticosterone levels were measured using the Sunlong Biotech CO., LTD kit. The results showed a significant decrease (p<0.01) in stress hormone levels in the third treatment group (gene silencing treatment), leading to notable physiological responses in the birds compared to the other treatments. This study highlights the impact of gene silencing on the physiological traits of wild birds and its effects on their physiological responses. The findings of this study are significant in the context of avian physiology and poultry farming. By elucidating the impact of stress hormones on egg production and demonstrating the efficacy of gene silencing as a method to enhance reproductive efficiency, this research opens new avenues for improving the productivity and well-being of wild birds in controlled environments. It also underscores the potential of genetic interventions in addressing physiological challenges in wildlife. Presentation: 6/1/2024

Uptake of biosimilars in China: a retrospective analysis of the case of trastuzumab from 2018 to 2023

BackgroundThe Chinese biosimilar industry has demonstrated rapid growth in recent years. Limited evidence is available about biosimilar uptake at the national level. This study aimed to assess biosimilar uptake in the case of trastuzumab and to explore potential factors influencing the biosimilar penetration at national and provincial levels.MethodsThis study employed an interrupted time series analysis to assess the level and trend changes of national trastuzumab originator consumption and the overall trastuzumab consumption after the price reduction of the originator and the introduction of the first biosimilar using the China Hospital Pharmacy Audit procurement data from March 2018 to February 2023. A latent class trajectory model (LCTM) was also adopted to estimate the biosimilar penetration across 30 provincial-level administrative divisions (PLADs). Based on the LCTM grouping results, provincial characteristics were analyzed.ResultsAfter rapid growth, the penetration of biosimilars demonstrated a moderate ascending trend at the national level, reaching 27% in February 2023. Following the introduction of the first biosimilar in July 2021, the consumption of the originator decreased by 0.5% per month (P = 0.008), and the growth rate of overall trastuzumab consumption decreased by 1.1% per month (P = 0.014). LCTM fit the best when the number of trajectory classes was two, dividing 30 PLADs into a group demonstrating a faster increase in biosimilar penetration and the other with a slower increase. The PLADs in the fast-increasing group had a higher proportion of the population covered by the national basic health insurance, a lower proportion of the urban population, a lower proportion of the population covered by the urban employee health insurance program, a lower gross domestic product per capita, a lower total health expenditure per capita, and a lower out-of-pocket expenditure.ConclusionsThe uptake of trastuzumab biosimilars in China was lower compared with major European countries. The introduction of trastuzumab biosimilars presented a substitutional effect. Perceptions of physicians and patients, the medicines procurement model, competition from other biologics, and health insurance payment methods may influence biosimilar uptake. Enhancing a comprehensive understanding of biosimilars among physicians and patients, including biologics with biosimilars in the national pooled procurement, and implementing provider payment reforms could foster biosimilar penetration.

Test-Retest Reliability, Clinical Usefulness, and Telephone Application of the Work Limitation Questionnaire in Individuals Who Returned to Work After Stroke.

To measure the test-retest reliability and the clinical usefulness of the Work Limitation Questionnaire, and to compare the in-person with the telephone application. Cross-sectional, exploratory study. The Work Limitation Questionnaire was answered three times: twice in person, to measure test-retest reliability and clinical usefulness, and once, by telephone, to measure the validity of the telephone application. Fifty-six individuals (32 men) with mild to moderate disabilities after stroke were included. Test-retest reliability was very high (ICC 0.96; 95% CI 0.94 to 0.98; p < 0.01), the clinical usefulness was high (9 out of 12 points), and the correlation between in-person and telephone applications was high (ρ = 0.7; 95% CI 0.5 to 0.9; p < 0.01). The average productivity loss was 4% (SD 5, min-max 0 to 15%). The Work Limitation Questionnaire showed adequate test-retest reliability and clinical usefulness in individuals with stroke. The telephone application produced comparable results to in-person applications. The participants reported low productivity loss, which may be related to the mild impairments of the included sample.

6705 Sheehan syndrome: a case report

Abstract Disclosure: F.S. Rodrigues: None. C.C. Silva: None. W. Da Silva: None. T.M. Caldas: None. L. Rocha: None. Introduction: Sheehan's Syndrome, or postpartum hypopituitarism, is characterized by hyperplasia and an increase in the number of prolactin-secreting cells, secondary to a major hemorrhagic event occurring during or after childbirth. In this situation, the anterior pituitary gland can increase in size and suffer ischemia due to vascular hypoflow. Consequently, there is low production of one or more of the hormones produced by the gland, which can generate heterogeneous clinical presentations. As a preventive treatment, polytransfusion is recommended in cases of large hemorrhage. OBJECTIVE: To present a case of Sheehan’s Syndrome, which developed after a birth complicated by a major hemorrhagic event, even after receiving polytransfusion. CASE REPORT: A woman, 45 years old, being monitored at the endocrinology outpatient clinic for 2 years. As a history, there was a severe hemorrhage during her cesarean section, which occurred 30 years ago, in which she received a blood transfusion of a total of 1.2 liters of packed red blood cells. 7 years ago, she was diagnosed with hypothyroidism and 2 years ago with hyperprolactinemia. In 2022, she was also diagnosed with adrenal insufficiency. At that time, she underwent a magnetic resonance imaging (MRI) scan of the sellaturcica region, which was found to be partially empty. The patient's recent exams showed TSH: 3.15 μUI/mL (0.4-4.0); Free T4: 0.88 ng/dL (0.93-1.7); Cortisol 8h: 8 μg/dL (5-25); LH: 15 mIU/mL (1.1-14.7); FSH: 43 mIU/mL (2.8-9); Estradiol: 8 ng/dL (12.4-398); Prolactin: 28 ng/mL (1.9-25), basal GH 0’ 0.054/30’ 2.51/60’ 2.48/90’ 3.74 ng/mL (up to 10), ACTH 17 pg/mL (up to 46). Since then, she has been undergoing endocrinological monitoring for hormone replacement therapy to treat the hormonal changes caused by late-diagnosed Sheehan Syndrome. DISCUSSION: Sheehan's Syndrome is a rare disease, characterized by low blood flow and necrosis of the pituitary gland due to postpartum hemorrhage. The diagnosis results from obtaining a good clinical history associated with hormonal levels. This patient presented significant bleeding after cesarean section requiring transfusions. However, despite transfusions, the patient developed hypothyroidism, hyperprolactinemia, and adrenal insufficiency. The MRI confirmed the suspected diagnosis, showing the partially empty sellaturcica. Conclusion: The diagnosis of Sheehan Syndrome is based on very broad clinical manifestations, with MRI of the sellaturcica contributing to confirming the diagnosis. Although the preventive treatment is blood transfusion, the patient developed the disease, highlighting the need for continued monitoring of pregnant women with a history of significant bleeding during childbirth. Therefore, outpatient monitoring of the patient is necessary with a focus on hormonal levels so that clinical complications are avoided. Presentation: 6/2/2024