Production Wells Research Articles

Housing cost overburden and population health: cross-country evidence from Europe before the pandemic

ABSTRACT The recent surge in housing prices across Europe has placed a considerable financial burden on families, with potential effects across multiple dimensions, including health. This study investigates the relationship between housing cost overburden and self-assessed health status and premature mortality across 26 European Union countries between 2011 and 2019, before the pandemic. We estimate a general health production function using a generalised least squares regression with both robust and Driscoll – Kraay standard errors. We conduct a quantile regression via the method of moments to provide additional insights into the relationship between health and housing cost overburden along the distribution of health variables. Controlling for socio-demographic and economic country profiles, our results confirm that housing cost overburden is associated with worse health status. The association with premature mortality appears to be stronger in countries with lower rates of premature mortality or with a lower share of people reporting lower health status, suggesting that housing cost overburden is an important health determinant. In these well-performing countries, even modest improvements in addressing the housing cost burden may contribute to improve health outcomes.

Soybean nodulation shapes the rhizosphere microbiome to increase rapeseed yield.

Crop rotation, a crucial agricultural practice that enhances soil health and crop productivity, is widely used in agriculture worldwide. Soybeans play a crucial role in crop rotation owing to their nitrogen-fixing ability, which is facilitated by symbiotic bacteria in their root systems. The soybean-rapeseed rotation is an effective agricultural practice in the Yangtze River Basin of China. However, the mechanism underlying the effectiveness of this system remains unknown. The aim of this study was to decipher the mechanisms by which previous soybean cultivation enhances the growth of subsequent rapeseed. Soybeans with three distinct nodulation genotypes were rotated with rapeseed, and the impact of previous soybean cultivation on subsequent rapeseed growth was evaluated by examining the soybean root secretome and soil rhizosphere microbiome. Soybean-rapeseed rotation significantly enhanced subsequent rapeseed growth and yield, especially when supernodulating soybean plants were used, which released the most nitrogen into the soil rhizosphere. The differences in soybean nodulation capability led to variations in root exudation, which in turn influenced the bacterial communities in the rhizosphere. Notably, the supernodulating soybean plants promoted Sphingomonadaceae family of bacteria growth by secreting oleic acid and cis-4-hydroxy-D-proline, and further attracted them through cis-4-hydroxy-D-proline. Furthermore, the exogenous application of Sphingomonadaceae bacteria, either alone or in combination with rhizobia, significantly enhanced the growth of rapeseed. Our data definitively demonstrated the crucial role of previous soybean cultivation in enhancing the yield of rapeseed, with the assistance of Sphingomonadaceae bacteria and rhizobia. This study elucidates the role of soybean nodulation in rhizosphere bacterial dynamics, highlighting its importance in sustainable agricultural practices.

Establishing a Unified Framework for Natural Health Product Quality: Insights from North American Naturopathic Practitioners

Establishing a Unified Framework for Natural Health Product Quality: Insights from North American Naturopathic Practitioners

Effect of Fermentation Time on the Antioxidant and Antibacterial Activity of Fermented Cascara Beverage

Indonesia is a country with a high consumption of coffee, which is in direct comparison with the increased production of coffee waste. Arabica coffee husk (cascara) is coffee industry waste that has not been utilized optimally, which is only 0.76% of the existing potential. Cascara is known to have a secondary metabolite compound that can be utilized as a good product for human health. The effects of Arabica cascara fermentation time on the antioxidant and antibacterial activity of cascara beverage were studied in this study. This research is using a completely randomized non-factorial design. Cascara was obtained from Puntang Mountain, West Java, and was fermented with Lactiplantibacillus plantarum (previously known as Lactobacillus plantarum) for 10, 14, and 18 days. pH value was measured with a pH meter, total sugar content with phenol sulfuric acid method, caffeine content with high performance liquid chromatography (HPLC) method, total lactic acid bacteria (LAB) with drop plate method, total flavonoid and phenolic content with UV-Vis spectrophotometry method, antioxidant activity with 2,2-diphenyl-1-picrylhydrazyl (DPPH) method, and antibacterial activity against Helicobacter pylori with disc diffusion method. Data were analyzed using One-Way ANOVA and DMRT test at the significance level of 0.05. The results showed that prolonged fermentation times reduce the quality of Arabica cascara beverage. The optimal fermentation times were found to be 10 days producing the best balance of pH (3.66), total sugar content (1.29%), caffeine content (0.043%), total LAB (1 x 107), total phenols (12.74 ppm), total flavonoids (3.40 ppm) and highest antioxidant IC50 activity (215 ppm) while for antibacterial activity has not been able to inhibit the growth of Helicobacter pylori.

Smart Buff Manager: A Co-Designed Mobile Application for Enhancing Buffalo Farm Management in Thailand

This study focuses on the co-design and development of a smartphone application, the "Smart Buff Manager," especially for smallholder buffalo farmers in Thailand. The application aims to meet the needs of buffalo farmers by providing an effective and user-friendly tool for record-keeping and farm management. We employed the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) instructional design method to ensure the application addressed the practical needs and preferences of the farmers. The primary features of the app include record-keeping, health monitoring, and breeding management, focusing on various issues faced by smallholder farmers. The user-centered design method provides an intuitive interface that gathers feedback from users, resulting in increased satisfaction and a higher tendency to recommend apps. Implementation of the app significantly improved farm management by enhancing operational efficiency, productivity, and animal welfare. Users of the application reported much greater compliance with vaccination schedules than non-users, potentially improving herd health and long-term production. This case study confirms the potential of mobile technology to improve farm operations and decision-making while also highlighting the essential role of involving end-users in the design process to develop appropriate and effective digital farming systems.

Rhizobacterial Isolates from the Native Plant Ceanothus velutinus Promote Growth in Two Genotypes of Tall Fescue

Global warming-induced climate change haunts the world, posing a critical threat to plant health and crop production. Overusing chemical fertilizers and pesticides poses a significant threat to soil health. Ceanothus velutinus (snowbrush) is a drought-tolerant, actinorhizal native plant found in the Intermountain West region of the US that harbors many plant growth-promoting rhizobacteria (PGPR). In this study, we evaluated the effects of PGPR CK-06, CK-22, CK-44, and CK-50 from C. velutinus on the growth and development of two tall fescue genotypes: (i) a lawn-type tall fescue blend and (ii) an endophyte-free forage-type tall fescue known as Armory. Tall fescue plants were grown in field soil and sand mix in pots and treated twice with 5 mL of bacterial inoculum. Two isolates, CK-06 and CK-22, significantly increased tiller numbers (p < 0.05) in the lawn-type tall fescue blend, and all isolates showed a significant increase in fresh and dry weight compared to the control. Isolate CK-22 significantly increased the tiller number and fresh and dry weight of the forage-type tall fescue Armory compared to the control. Isolates CK-44 and CK-50 tested positive for sulfur-oxidizing properties, and CK-44 was able to restore the sulfur content in sulfur-deficient soil compared to the control.

Training on Processing Natural Resources into Processed Food and Health Products for Mothers in Tondongggeu Village, Nambo District, Kendari City

This community service activity is a training activity on the manufacture of health and food products that have the opportunity to improve the community's economy as well as providing education on the use of moringa leaves as face masks and papaya fruit as an analog tomato sauce to mothers in Tondonggeu Village, Nambo District, Kendari City. Tomato sauce is generally made from tomato raw materials, but it can also be made from other ingredients so it is called an analog tomato sauce. Tomato sauce is generally made from tomato raw materials, but it can also be made from other ingredients so it is called an analog tomato sauce. Papaya as a substitute for tomatoes in making analog tomato sauce can be done because papaya has characteristics like tomatoes, namely color, organic acid content, and viscosity, even papaya has a higher vitamin C level than tomatoes. Moringa leaves contain many vitamins, including vitamin A, vitamin C, amino acids and antioxidants such as flavonoids, quercetin and zeatin which function to maintain dry skin hydration and prevent the appearance of wrinkles, because it helps fight free radicals, so it is very good to be used as a cosmetic ingredient in the form of a face mask. Participants in this training involved residents of Tondonggeu village, Thematic KKN students and a team of accompanying lecturers from the Biotechnology and Biology study program of FMIPA Halu Oleo University. The training methods used are lectures, demonstrations and discussions. The lecture method was carried out with the aim of providing information and knowledge about moringa masks and analog ketchup. The demonstration aims to provide skills to mothers through the practice of directly processing moringa leaves into masks and papaya fruits into analog tomato sauce while the discussion is intended to show the activeness and understanding of the community during the training process. The results of the training on making masks and analog tomato sauce carried out by mothers are in the good category with an average success of 85%, their response to the implementation of the training is very good as seen from the enthusiasm of the residents to participate in the activity from the beginning to the end. This training activity can increase knowledge and improve mothers' skills in producing moringa masks and papaya analogue tomato sauce.

Effect of Annual Leave Days on Presenteeism - a Cohort Study in Employees of a Japanese Corporate Group.

This study investigated the association between leave use and improvement of work functioning impairment affecting presenteeism. A prospective, observational study was conducted among 5,752 employees in a single corporate group in Japan to analyze the number of days of leave taken over a one-year period and changes in work functioning impairment. As the number of leave days increased, work functioning impairment improved significantly. These results suggest that allowing employees to take more leave significantly contributes to improving work functioning impairment. Companies need to promote appropriate leave use to improve employee health and overall work productivity.

Plant growth-promoting Bacillus amyloliquefaciens orchestrate homeostasis under nutrient deficiency exacerbated drought and salinity stress in Oryza sativa L. seedlings.

Nutrient deficiency intensifies drought and salinity stress on rice growth. Bacillus amyloliquefaciens inoculation provides resilience through modulation in metabolic and gene regulation to enhance growth, nutrient uptake, and stress tolerance. Soil nutrient deficiencies amplify the detrimental effects of abiotic stresses, such as drought and salinity, creating substantial challenges for overall plant health and crop productivity. Traditional methods for developing stress-resistant varieties are often slow and labor-intensive. Previously, we demonstrated that plant growth-promoting rhizobacteria Bacillus amyloliquefaciens strain SN13 effectively alleviates stress induced by sub-optimum nutrient conditions in rice. In this study, we evaluated the effectiveness of SN13 in reducing the compounded impacts of drought and salinity under varying nutrient regimes in rice seedlings. The results demonstrated that PGPR inoculation not only improved the growth parameters, nutrient content, and physio-biochemical characteristics under nutrient-limited conditions, but also reduced the oxidative stress markers. The altered expression of stress-related and transcription factor genes (USP, DEF, CYP450, GST, MYB, and bZIP) revealed the regulatory effect of PGPR in enhancing stress tolerance through these genes. GC-MS-based untargeted metabolomic analysis revealed that PGPR significantly influenced various metabolic pathways, including galactose metabolism, fructose and mannose metabolism, and fatty acid biosynthesis pathways, suggesting that PGPR affects both energy production and stress-protective mechanisms, facilitating better growth and survival of rice seedlings.

Esketamine infusion as treatment for chronic endometriosis-associated pain? Study protocol for a randomized controlled trial (EASYlight-study)

Current treatment options for chronic endometriosis-associated pain are often inadequate, resulting in a rise in opioid consumption in this population. Given its analgesic, anti-inflammatory, and anti-depressive properties, esketamine may be a promising alternative treatment option. While esketamine is globally used in the treatment of chronic pain conditions, no clinical trials have been conducted to investigate the efficacy of esketamine infusion to alleviate chronic endometriosis-associated (pelvic) pain. Therefore, the objective of this double-blinded randomized controlled trial (RCT) is to assess the efficacy of 8-h infusion with esketamine versus placebo (saline) to reduce chronic endometriosis-associated pain symptoms. Secondary study objectives include pain scores, quality of life, depressive symptoms, health care utilization, productivity loss, cost-effectiveness, side effects, treatment experience, and pain coping and cognition. Premenopausal women (aged ⩾18 years) diagnosed with endometriosis (peritoneal, ovarian, deep, or adenomyosis), with an indication for laparoscopic endometriosis resection surgery and who suffer from chronic pelvic pain (NRS score ⩾6) will be eligible for inclusion. In total, we aim to include 56 participants, with a follow-up of 12 weeks. Digital questionnaires will be sent at baseline and 4, 8, and 12 weeks after the day of infusion. Trial registration number The EASYlight study is registered as “EASYlight-NEK” in the Clinical Trials Register (NCT06161805)

Exploring the Biological Activity of Phytocannabinoid Formulations for Skin Health Care: A Special Focus on Molecular Pathways.

Recent advancements have highlighted the potential of cannabis and its phytocannabinoids (pCBs) in skin health applications. These compounds, through their interaction with the endocannabinoid system (ECS), show promise for skin health products. Their ability to regulate inflammation, oxidative stress and cell proliferation makes them useful in addressing skin problems such as inflammation, scarring, healing, acne and aging, positioning them as valuable tools for innovative skincare solutions. In the present work, the cellular and molecular effects of proprietary pCB-based formulations on ECS modulation, inflammation and skin regeneration were investigated. Using human dermal fibroblasts (HDF) and keratinocytes (HaCaT), the effect of formulations in both pre-treatment and treatment scenarios following exposure to stress-inducing agents was assessed. Key molecular markers were analyzed to tackle their efficacy in mitigating inflammation and promoting structural integrity and regeneration. In vitro results showed that these formulations significantly reduced inflammation, promoted skin regeneration and improved structural functions. In vivo studies confirmed that the formulations were well-tolerated and led to noticeable improvements in skin health, including enhanced barrier function. This study demonstrates the safety and efficacy of pCB-based formulations for cosmeceutical applications. By combining molecular analysis with in vivo testing, this research provides new insights into the therapeutic potential of pCBs for managing various skin conditions.

The Tayyib Element in Food and Health Products in Malaysia: An Evaluation

The Tayyib Element in Food and Health Products in Malaysia: An Evaluation

Morphological and physiological responses of Momordica charantia to heavy metals and nutrient toxicity in contaminated water

This study investigates the impact of industrial wastewater from leather, household, and marble sources on the growth, physiological traits, and biochemical responses of Momordica charantia (bitter melon). Industrial activities often lead to the release of contaminated effluents, which can significantly affect plant health and agricultural productivity. Water analysis revealed that leather effluent contained high concentrations of heavy metals, including cadmium (2.67 mg/L), lead (1.95 mg/L), and nickel (1.02 mg/L), all of which exceeded the recommended safety limits for irrigation. Seed germination was significantly reduced, with only 45% germination in seeds irrigated with leather effluent, compared to 90% in the control group. Similarly, in plants treated with leather wastewater, shoot length, and root length were reduced by 38% and 42%. Chlorophyll content showed a marked decline, with chlorophyll “a” reduced by 25% and chlorophyll “b” by 30% in wastewater-treated plants, indicating impaired photosynthetic activity. Antioxidant enzyme activity, including catalase and superoxide dismutase, increased by up to 40%, reflecting a stress response to heavy metal toxicity. These findings highlight that industrial wastewater severely disrupts plant metabolic processes, leading to stunted growth and physiological stress. To safeguard crop productivity and food security, stringent wastewater treatment protocols must be implemented to mitigate environmental contamination. Future research should focus on developing advanced remediation techniques and sustainable wastewater management practices to reduce heavy metal toxicity and enhance soil health.

Omega-3 Levels in Prenatal Supplements.

This study aimed to systematically document the reported omega-3 levels in commercially available prenatal supplements in the United States and Canada, and compare these levels to recommended intakes in pregnancy. Commercial prenatal supplements were identified using the Dietary Supplement Label Database (n = 50) and the Licensed Natural Health Products Database (n = 18). Mean omega-3 levels and the proportion of products meeting recommendations for pregnant women were tabulated. Average omega-3 levels were 368 ± 33 mg in the United States and 404 ± 72 mg in Canada. Seventy percent of products in the United States and 61% in Canada contained the amount of omega-3 levels recommended for pregnant women with sufficient intakes. Sixteen percent of products in the United States and 28% in Canada contained the dose recommended for pregnant women with insufficient intakes. These results illustrate that commercial prenatal supplements contain a wide variety of omega-3 fatty acid levels that may or may not be consistent with recommended intake levels. · most pregnant women consume inadequate amounts of omega-3 fatty acids.. · omega-3 fatty acids can help prevent preterm birth.. · new guidelines recommend increased intakes of omega-3 fatty acids during pregnancy.. · prenatal supplements contain a wide variety of omega-3 fatty acid levels.. · omega-3 levels in prenatal supplements may or may not be consistent with recommended intake levels..

THE INFLUENCE OF FAMILY SOCIO-ECONOMICS AND SOCIAL SUPPORT FROM THE FAMILY SUPPORT TEAM ON STUNTING (Cases in Families at Risk of Stunting in Purwadadi District, Ciamis Regency, 2024)

The problem of stunting which a part of the double burden of malnutrition has a very detrimental impact both in terms of health and economic productivity. The causes of stunting are divided into specific factors and sensitive factors. Sensitive factors that are considered to have an influence on the incidence of stunting are the family's socio-economic and also the social support provided by the family support team who have an important role in efforts to prevent stunting. The socio-economic factors that influence the incidence of stunting in risk of stunting families in Purwadadi District are the level of education from the parents, family income level, participation in family planning programs as a contraception acceptor and the number of children in the family. All forms of social support provided by the family support team in the form of informational, instrumental, emotional, appreciation and friendship/social integration support have an influence on the incidence of stunting in families at risk of stunting in Purwadadi District. The social support from the family support team on stunting that has the most dominant influence on the incidence of stunting in families at risk of stunting in Purwadadi District was informational support and friendship/social integration support.

Management of Broodstock for Pacific White Shrimp (Litopenaeus vannamei) at the Center for Superior Shrimp and Shellfish Broodstock Production (BPIU2K) Karangasem, Bali

Shrimp (Litopenaeus vannamei), as it directly impacts the quality and quantity of larvae produced for aquaculture. This study investigates the management practices at the Center for Superior Shrimp and Shellfish Broodstock Production (BPIU2K) in Karangasem, Bali, focusing on the broodstock selection, breeding, and maintenance processes. The research evaluates the performance of broodstock in terms of growth, reproductive health, and overall productivity, aiming to optimize practices for sustainable shrimp farming. Data was collected through direct observation, water quality analysis, and broodstock health assessments. The findings highlight the importance of proper environmental conditions, nutritional management, and genetic selection in enhancing the reproductive success of L. vannamei. The study also discusses challenges faced by the facility, including disease management and genetic diversity, offering recommendations for improving broodstock management to ensure consistent, high-quality shrimp production. The number of male broodstock in the maintenance tank was around 250, and female broodstock was around 200, with a survival rate of 70%. This research contributes to advancing sustainable aquaculture practices and improving the shrimp farming industry in Indonesia.

Specific Recommendations for the Evaluation of Orphan Drugs in Spain: The EvalRare project

Introduction and Objective: Rare diseases (RDs) are low-prevalence conditions that significantly impact patients’ lives, often requiring orphan drugs (ODs) for treatment. This study aims to establish a national framework for assessing the quality of clinical evidence for ODs in Spain, to better manage associated uncertainties and support informed decision-making by stakeholders. Materials and Methods: A qualitative study using focus group methodology was carried out. A review was conducted to identify evaluation criteria from Therapeutic Positioning Reports (TPRs) by the Spanish Agency for Medicines and Health Products (AEMPS) and the GENESIS group of the Spanish Society of Hospital Pharmacy (SEFH). A multidisciplinary focus group of experts from national, regional, and hospital levels discussed and refined these criteria, proposing new variables and reaching consensus on final recommendations. Results: Key evaluation criteria were identified, including study design, comparison type, primary clinical endpoints, study population, and study duration. Recommendations were categorized by acceptability, addressing the specific challenges in OD development. While randomized clinical trials remain the gold standard, alternative designs, such as uncontrolled non-randomized cohort studies, may be acceptable under certain conditions, particularly when there is a significant unmet medical need and no alternative therapies. Both clinical endpoints and validated quality of life metrics are crucial in assessing ODs. Smaller sample sizes and shorter study durations may be acceptable if justified by the disease’s characteristics and the clinical relevance of the outcomes. Conclusion: The proposed framework offers a tailored guide for evaluating the clinical evidence of ODs, providing recommendations that may enhance decision-making by stakeholders for determining patient access to OD treatments. Key words: orphan drugs, evaluation, research methodology, health decision-making, recommendations, rare diseases.

A large, multi-site lipidomic investigation of parity and aging in dairy cows.

Efforts to optimize the longevity of dairy cows are hindered by the increased risk of adverse health events, culling or dying on farm with increased parity. Lipidomics provides a platform to help identify important biomarkers and biological pathways associated with increased parity and associated aging. A large, multi-site (15 pasture-based, 15 TMR farms) cross-sectional study collected plasma samples from nonlactating, late pregnant, 'dry' cow (696 cows, ~27 d prepartum) and peak-milk cows (796 cows, ~58 DIM) in a disproportionate stratified (parity: 0, 1, 2, > 2 for dry cows; 1, 2, 3, > 3 for peak-milk cows) random sampling frame. A total of 185 lipid species, comprising the lipids classes of phospholipids, sphingomyelins (SM) and triacylglycerols, were quantified in a targeted, liquid chromatography-mass spectrometry (LC-MS) approach. Dry and peak-milk cohorts were analyzed separately throughout. Variation in lipid profiles was mostly attributed to farm of origin (36-41% of variation), with feeding system explaining 13-21% and parity 6-9%, according to ANOVA simultaneous component analysis (ASCA) modeling. Multiple linear regression (MLR) and orthogonal-partial least squares (O-PLS) investigated the association of the lipid profile with age (d), while discriminate analysis compared 1st parity with > 3 parity cows in O-PLS discriminate analysis (O-PLS-DA), random forest (RF) and support vector machine (SVM) models. Rankings of the most important lipid species for each model type were compared. Phospholipids with 40 carbon atoms and 6 double bond equivalents (40:6) were consistently decreased with increasing parity and age across both dry and peak-milk cohorts. These lipids most likely contained stearate (18:0) and docosahexaenoic acid (DHA, C22:6;n-3), an omega-3 fatty acid. Additionally, phospholipids with 40:5, 38:6, lysophosphatidylcholine (17:0), SM(35:1), and SM(35:2) were commonly identified lipids that decreased in concentration with parity and age. Docosahexaenoic acid has been associated with improved cattle health, reproduction, and milk production and quality. This study raises the hypothesis that reduced DHA levels in older cows may be a significant factor increasing susceptibility to adverse health events, reduced reproductive performance, and herd removal. Studies that supplement DHA or its precursors can test this hypothesis and may be important in optimizing longevity of cows.

Innovative Organic Fertilizers and Cover Crops: Perspectives for Sustainable Agriculture in the Era of Climate Change and Organic Agriculture

Anthropogenic activities have resulted in land desertification in various regions of the world, leading to the degradation of critical soil characteristics such as organic matter (OM) content, nutrient stock, and prevailing biodiversity. Restoring such degraded soils through organic matter amendments and diversified crop rotations is thus an intrinsic part of organic farming. This review discusses a wide range of organic farming impacts on soil health and crop productivity by focusing on organic fertilizers and crop diversification. Conventional fertilizers were considered vital for agricultural production to harvest high crop yields. Nevertheless, they are now deemed as environmentally hazardous and an obstacle to sustainable agroecosystems due to intensive chemical inputs that damage the soil over time and have long-lasting impacts. Conventional fertilization results in nutrient depletion, loss of microbial diversity, organic matter reduction, and deterioration of physical characteristics of the soil. Conversely, organic fertilization makes use of naturally existing resources to improve soil health. Organic amendments such as biochar, manure, and fermented grass improve soil’s physical, chemical, and biological properties and promote the growth and diversity of beneficial soil microorganisms—important in nutrient cycling and soil stability. They facilitate the uptake of nutrients, hinder crop pathogen growth, mitigate heavy metals, and decompose xenobiotic organic substances. Moreover, growing cover crops is also a major strategy to improve soil health. Diversified crop rotation with combinatorial use of organic fertilizers may improve soil health and agricultural yields without any detrimental impacts on the environment and soil, ensuring sustainable food production, safety, and security. This integrated approach contributes to minimizing the use of chemical fertilizers and their effects on environmental health. It also contributes to reducing agricultural inputs along with enhancing OM, soil microbial diversity and biomass, nitrogen fixation, and carbon sequestration. Therefore, cover crops and organic fertilization may offer sustainable agroecosystems and climate change mitigation.

How can the reform of the activity-based payment system (T2A) help in financing innovative health products?*

In France, the short-stay activities of public and private sector healthcare facilities have been financed since 2004 by activity-based pricing (T2A). The principle is to allow for payment determined primarily by the nature and volume of activities. T2A has enabled a major transformation compared to the old financing system, chiefly for public sector facilities that used to operate under a general allocation, and convergence between payment methods in the public and private sectors. However, official reports and public pronouncements by many hospital healthcare stakeholders have also highlighted the limits of this method of financing, leading to several reform projects. With that in mind, round table3 of the Giens Workshops, including experts from academia and/or hospitals, institutions, and industry, questioned the impact of the new T2A reforms on access to innovative health care products in hospitals. After scoping out the issue and drawing up observations, the round table proposed six general recommendations that would be avenues for improving access to innovative health care products for hospital service users.