Reform of economic evaluation of medicines in Spain: proposals from the Advisory Committee for Pharmaceutical Financing.

This paper describes the reforms recommended by the Advisory Committee on the Financing of Pharmaceuticals (CAPF) for the National Health System (NHS) of Spain from 2019 to 2024 for the drug pricing and reimbursement process, to integrate economic evaluations and improve efficiency and sustainability. The CAPF has proposed a three-phase reform of the economic evaluation (EE) and budget impact analysis (BIA) processes. The first phase involves the mandatory submission of EE and BIA by applicants for new drugs.

Understanding the microbial processes on carbon brushes that accelerate methanogenesis of long-chain fatty acids in anaerobic digestion.

Lipids offer high energy recovery potential during anaerobic digestion (AD), but their hydrolysis generates long-chain fatty acids (LCFAs), which are difficult to biodegrade. The introduction of microbial electrolysis cells has been widely recognized as a promising strategy to enhance AD. However, it is still under debate whether the electrical circuit needs to be connected, as certain electrodes with large specific surface areas have been reported to enhance direct interspecies electron transfer (DIET) without requiring an external power supply.

Dual-purpose elemental sulfur for capturing and accelerating biodegradation of petroleum hydrocarbons in anaerobic environment.

Hydrophobic organic pollutants in aqueous environments are challenging to biodegrade due to limited contact between microorganisms, the pollutants and the electron acceptor, particularly under anaerobic or anoxic conditions. Here, we propose a novel strategy that uses inexpensive, dual-function elemental sulfur (S) to enhance biodegradation. Using petroleum hydrocarbons as the target pollutants, we demonstrated that hydrophobic and nonpolar S° can concentrate hydrocarbons while simultaneously serving as an electron acceptor to enrich hydrocarbon-degrading bacteria.

Electroencephalogram monitoring during anesthesia and critical care: a guide for the clinician.

Perioperative anesthetic, surgical and critical careinterventions can affect brain physiology and overall brain health. The clinical utility of electroencephalogram (EEG) monitoring in anesthesia and intensive care settings is multifaceted, offering critical insights into the level of consciousness and depth of anesthesia, facilitating the titration of anesthetic doses, and enabling the detection of ischemic events and epileptic activity. Additionally, EEG monitoring can aid in predicting perioperative neurocognitive disorders, assessing the impact of systemic insults on cerebral function, and informing neuroprognostication.

Exploring the uptake of economic evaluation in Spanish reports positioning medicines for public reimbursement.

Therapeutic positioning reports (IPTs, Spanish acronym) are a crucial tool for informing funding and pricing decisions for drugs in the Spanish healthcare system. In 2020, for the first time the inclusion of economic evaluations (EEs) was explicitly set as a primary objective in a new Action Plan aimed at consolidating IPTs. This paper seeks to examine the uptake of EE into IPTs and to compare the methods and techniques employed in the EEs conducted during the two-year pilot phase following the reform, i.

Thermodynamics of the Primordial Universe.

This review delves into the pivotal primordial stage of the universe, a period that holds the key to understanding its current state. To fully grasp this epoch, it is essential to consider three fundamental domains of physics: gravity, particle physics, and thermodynamics. The thermal history of the universe recreates the extreme high-energy conditions that are critical for exploring the unification of the fundamental forces, making it a natural laboratory for high-energy physics.

[Analysis of equity and budgetary sustainability of the pharmaceutical co-payment system in Spain].

Objective: To estimate the impact of a more equitable pharmaceutical co-payment system by eliminating the distinction between active workers and pensioners, using only personal income as an adjustment parameter, defining more detailed income brackets, and introducing protective limits on personal expenditure.

Method: Data from a random sample of 4,505,483 individuals residing in Spain were used, matching pharmaceutical consumption information from the Ministry of Health with economic data from the Tax Agency. Five microsimulation scenarios were designed, modifying co-payment percentages and monthly limits, and the effects on public pharmaceutical spending, the economic burden between patients and the Spanish National Health System, and the redistribution of the burden among patient groups were evaluated.

The Association Between Perioperative Red Blood Cell Transfusions and 1-Year Mortality After Major Cancer Surgery: An International Multicenter Observational Study.

Background: Packed red blood cell (pRBC) transfusions in patients undergoing surgery for cancer are given to treat anemia or acute hemorrhage. Evidence indicates that pRBC transfusions are associated with poor perioperative and oncological outcomes. The ARCA-1 (Perioperative Care in the Cancer Patient-1) study was designed to test the association between perioperative pRBC transfusions and postoperative morbidity and mortality in patients undergoing cancer surgery.

[Specific proposals for organising an agency for evaluating the efficiency of health technologies and policies].

We describe in detail a twofold proposal for the creation, organization and sequential development of two bodies responsible for evaluating the efficiency of health technologies and policies in Spain and its possible design. It would constitute a key element in the process of re-organising the National Health System. The first, which could be adopted immediately, would be called the Office for the Evaluation of the Efficiency of Medicines, would be attached to the Spanish Agency for Medicines and Medical Devices as a functionally independent body and limited to evaluating the efficiency of medicines.

Gastrointestinal nematodes in Cuniculus paca (Linnaeus, 1766) from hunting fauna in the Western Amazonian region.

Cuniculus paca, commonly known as the paca, is a rodent of the Cuniculidae family that is widely distributed throughout the Americas, including all Brazilian territories, and is abundant in the Amazon region. It is one of the most hunted species and faces significant predation in the extreme western Amazon region of Brazil because it constitutes a staple in the diet of local communities, for subsistence and commercial purposes. Understanding the helminthic fauna of these animals is of paramount importance, given that some nematodes have zoonotic potential and may pose risks to consumer health.

Cultural stressors, youth coping, and mother-adolescent conflict.

Objective: This study examined the associations between cultural stressors (i.e., foreigner-based discrimination and acculturation gap conflict) and mother-adolescent relational conflict and the moderating effects of youth coping on these relations.

Language proficiency and ethnic-racial orientation among Latine mother-adolescent dyads.

Language proficiencies have implications for how parents and children can communicate effectively and how culture and heritage can be transferred across generations. Previous research has sought to understand the relationship between parent language (mainstream, heritage) proficiencies and the ethnic-racial orientation of their children, though prior studies have not investigated the relationship between child language proficiencies and parent ethnic-racial orientation. This study examined the actor-partner effects of Latine mother-child dyads (N = 175; youth mean age = 12.

Development of a New Positron Emission Tomography Imaging Radioligand Targeting RIPK1 in the Brain and Characterization in Alzheimer's Disease.

Targeting receptor-interacting protein kinase 1 (RIPK1) has emerged as a promising therapeutic stratagem for neurodegenerative disorders, particularly Alzheimer's disease (AD). A positron emission tomography (PET) probe enabling brain RIPK1 imaging can provide a powerful tool to unveil the neuropathology associated with RIPK1. Herein, the development of a new PET radioligand, [C]CNY-10 is reported, which may enable brain RIPK1 imaging.

Intraoperative use of processed electroencephalogram in a quaternary center: a quality improvement audit.

Although intraoperative electroencephalography (EEG) is not consensual among anesthesiologists, growing evidence supports its use to titrate anesthetic drugs, assess the level of arousal/consciousness, and detect ischemic cerebrovascular events; in addition, intraoperative EEG monitoring may decrease the incidence of postoperative neurocognitive disorders. Based on the known and potential benefits of intraoperative EEG monitoring, an educational program dedicated to staff anesthesiologists, residents of Anesthesiology and anesthesia technicians was started at Cleveland Clinic Abu Dhabi in May 2022 and completed in June 2022, aiming to have all patients undergoing general anesthesia with adequate brain monitoring and following international initiatives promoting perioperative brain health. All the surgical cases performed under General Anesthesia at 24 daily locations were prospectively inspected during 15 consecutive working days in March 2023.

Critical consciousness and anti-racist action as rooted in family processes.

Racially ethnically marginalized communities in the United States are exposed to structural and interpersonal forms of racism that have harmful effects on their health, wealth, education, and employment (Centers for Disease Control and Prevention, Racism and Health. https://www.cdc.

Alternative sensor montage for Index based EEG monitoring. A systematic review.

The main objective of this systematic review is to assess the reliability of alternative positions of processed electroencephalogram sensors for depth of anesthesia monitoring and its applicability in clinical practice. A systematic search was conducted in PubMed, Embase, Cochrane Library, Clinical trial.gov in accordance with reporting guidelines of PRISMA statement together with the following sources: Google and Google Scholar.

Non-invasive technology for brain monitoring: definition and meaning of the principal parameters for the International PRactice On TEChnology neuro-moniToring group (I-PROTECT).

Technologies for monitoring organ function are rapidly advancing, aiding physicians in the care of patients in both operating rooms (ORs) and intensive care units (ICUs). Some of these emerging, minimally or non-invasive technologies focus on monitoring brain function and ensuring the integrity of its physiology. Generally, the central nervous system is the least monitored system compared to others, such as the respiratory, cardiovascular, and renal systems, even though it is a primary target in most therapeutic strategies.

Electroencephalographic guided propofol-remifentanil TCI anesthesia with and without dexmedetomidine in a geriatric population: electroencephalographic signatures and clinical evaluation.

Elderly and multimorbid patients are at high risk for developing unfavorable postoperative neurocognitive outcomes; however, well-adjusted and EEG-guided anesthesia may help titrate anesthesia and improve postoperative outcomes. Over the last decade, dexmedetomidine has been increasingly used as an adjunct in the perioperative setting. Its synergistic effect with propofol decreases the dose of propofol needed to induce and maintain general anesthesia.

Micro-Addition of Silver to Copper: One Small Step in Composition, a Change for a Giant Leap in Biocidal Activity.

The use of copper as an antimicrobial agent has a long history and has gained renewed interest in the context of the COVID-19 pandemic. In this study, the authors investigated the antimicrobial properties of an alloy composed of copper with a small percentage of silver (Cu-0.03% wt.

Divergent immune microenvironments in two tumor nodules from a patient with mismatch repair-deficient prostate cancer.

Patients with prostate cancer (PC) generally do not respond favorably to immune checkpoint inhibitors, which may be due to a low abundance of tumor-infiltrating lymphocytes even when mutational load is high. Here, we identified a patient who presented with high-grade primary prostate cancer with two adjacent tumor nodules. While both nodules were mismatch repair-deficient (MMRd), exhibited pathogenic MSH2 and MSH6 alterations, had a high tumor mutational burden (TMB), and demonstrated high microsatellite instability (MSI), they had markedly distinct immune phenotypes.

COVID-19 in a Portuguese whole blood donor population.

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), leading to pneumonia and acute respiratory distress syndrome. The COVID-19 pandemic had a major impact on the stock of blood banks worldwide. This study aims to assess the prevalence of COVID-19 in a population of whole blood donors and analyze the possible association between blood group and susceptibility to the disease and the impact of adopting preventive measures against SARS-CoV-2 infection.