text stringlengths 1 6.27k | id int64 0 3.07M | raw_id stringlengths 2 9 | shard_id int64 0 0 | num_shards int64 16 16 |
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of NAFLD alone. | 900 | 4954767 | 0 | 16 |
Lipids and transaminase elevations in ARV-experienced PLWH switching to a doravirine-based regimen from rilpivirine or other regimens Background Doravirine (DOR) is a newly approved antiretroviral belonging to the class of non-nucleoside reverse transcriptase inhibitors (NNRTI), well tolerated and leading to an improve... | 901 | 258113598 | 0 | 16 |
DOR1 (-0.23, p = 0.315) and DOR2 (-0.19, p = 0.254). Triglycerides did not noticeably change. ALT significantly decreased in PLWH with a baseline level > 40 UI/mL. Conclusions PLWH on doravirine treatment showed different trends in blood lipids according to their previous regimen. In PLWH switching from RPV, minimal mo... | 902 | 258113598 | 0 | 16 |
both metabolic and hepatic safety were mainly analyzed in phase 3 studies [1,2]. Thus, we used information from a real-life setting to provide new data on these issues. To evaluate if the lipid-lowering effect is linked to the drug class or DOR-specific, we compared PLWH switching to a DORbased regimen from an RPV-incl... | 903 | 258113598 | 0 | 16 |
to the physician in more than 6 months leave the study and are considered lost to follow-up. If individuals stop using the cohort drug, they leave the study. AEs are collected prospectively as soon as they are clinically observed. The first participant was enrolled in the DOR cohort in February 2020 and the enrolment i... | 904 | 258113598 | 0 | 16 |
after enrollment. PLWH with protease inhibitors (PI) in the previous regimen were excluded, based on the previous results which showed that DOR had a better lipid profile compared to PIs [1]. At baseline, mean high-density lipoprotein cholesterol (HDL-C) was higher in DOR2 than in DOR1 and DOR3, whereas total cholester... | 905 | 258113598 | 0 | 16 |
baseline were not statistically significant and were similar between groups. As regards hepatic safety, in subjects with normal baseline ALT (≤ 40 UI/ dL), no groups showed a significant modification in ALT. In those with altered baseline ALT levels, a decline from baseline was observed in DOR3 (-26 UI/L, 95% CI -42, -... | 906 | 258113598 | 0 | 16 |
determining significant decreases in fasting total cholesterol and low-density lipoprotein [14][15][16]. Improvement in lipid profiles has also been described with TDF compared to other agents in clinical trials [17,18] and observational studies [19]. Such improvements were also observed in other populations such as HI... | 907 | 258113598 | 0 | 16 |
in those from RPV-containing and INSTI-containing regimens. The latter finding, although statistically significant, derived from a too-small sample (10 study participants) to be significant and needs to be cautiously interpreted and possibly confirmed in larger samples. This study has some limitations. First, the Infec... | 908 | 258113598 | 0 | 16 |
Formation of memristor nanostructures for RRAM memory by local anodic oxidation A layout of resistive random access memory was developed and manufactured based on TiO2 nanostructures obtained by the local anodic oxidation. It is shown that TiO2 nanostructures exhibit a stable memristor effect without carrying out an ad... | 909 | 139508698 | 0 | 16 |
technology and the formation of RRAM elements based on memristor structures by LAO method. Experiment In this work, a structure of RRAM elements was proposed, representing a cross-bar array of memristor structures containing an insulating SiO2 substrate, structures of the lower titanium electrodes, titanium ONS obtaine... | 910 | 139508698 | 0 | 16 |
showed that the produced structures had stable memristive properties (Fig. 3b). There was an insignificant increase in the resistance for both states, related to the further LAO process of the titanium film, when current-voltage characteristics were measured in air. Then, the memristive effect reproducibility of the re... | 911 | 139508698 | 0 | 16 |
Economic and value chain analysis to support an investigation and risk mitigation efforts on Marek’s disease in layers in the southern part of Thailand Background and Aim: Marek’s disease (MD) is a common lymphoproliferative disease affecting chickens and causing economic losses in commercial poultry. The MD outbreak w... | 912 | 255639859 | 0 | 16 |
without additional revenue returned incurred losses of 1995 USD. Conclusion: The VCA provided a better understanding of the layer and egg businesses in South Thailand and guided the development of questionnaires for outbreak investigation. The potential risk factor findings suggested the need for further exploration of... | 913 | 255639859 | 0 | 16 |
can survive for a month in litter or dust. This is an important factor in the transmission of MDV from the dust due to poor sanitation of poultry houses, inadequate downtime period, overstocking or high density, immunosuppression, stress and coinfection with other diseases, lack of vaccination, and contamination throug... | 914 | 255639859 | 0 | 16 |
recommended as it will facilitate and expedite the investigation when the disease is detected. Although, MD vaccine is used in some farms in Thailand, awareness of the need for disease notification and reporting are low among farmers in Thailand [17,18]. Although the disease now rarely occurs, it can cause high and per... | 915 | 255639859 | 0 | 16 |
the main sources of data that were used for the analysis. The response of all stakeholders for the VCA and the farmers was based on their knowledge of normal practice, management, and economic information of their farms. Moreover, before organizing the value chain workshop and questionnaire interview, the team of resea... | 916 | 255639859 | 0 | 16 |
of five registered slaughterhouses, one representative out of three egg collecting centers, and four local veterinary officers. Inputs from stakeholders were obtained during a workshop using semi-structured interviews and participatory epidemiological methods. The interview consisted of three sessions: • Session 1 -Sea... | 917 | 255639859 | 0 | 16 |
southern Thailand with a higher mortality rate in 2019 than in 2018 with an unknown cause or (2) layers in at least one house on the farm with at least four of the following clinical signs since January 2019: Growth retardation or non-uniformity at the same age, stunted growth, emaciation, depression, transient paralys... | 918 | 255639859 | 0 | 16 |
were identified based on risk practices and interaction between stakeholders using the definitions outlined (Table-1) [22]. Outbreak investigation Data gathered during the interviews were entered and managed by an Excel spreadsheet for verification and validation. Descriptive statistics of case farms were computed acco... | 919 | 255639859 | 0 | 16 |
the first scenario: Case farms with additional revenues due to compensation from insurance and slaughtered suspected hen. Assumptions: 1. According to the interviews, the average age at which layers are sold as spent hens is 532 days (76 weeks) 2. The costs of laboratory and veterinary service to diagnose and control t... | 920 | 255639859 | 0 | 16 |
estimation of the percentage of products moved from one stakeholder group to another and the price negotiated. Risky practices along the value chain were identified and used to support the development of questionnaires for the MD outbreak investigation. The top three risky practices were as follows: (1) A company witho... | 921 | 255639859 | 0 | 16 |
A total of 35 layer farms were interviewed. Most of the farms were small (<10,000 layers each) (n = 22/35, 63%), with closed housing or with net installed (n = 24/35, 69%), raising native chickens (n = 26/35, 74%), without MD vaccination certificates for the birds purchased from other provinces (n = 6/9, 67%), and with... | 922 | 255639859 | 0 | 16 |
birds of different ages (23%) and from different sources (14%) in the same house. The median length of the downtime period of the farms was 60 days ranging from 14 to 120 days. Regarding egg tray management, 33% of farms mixed inside egg trays and outside egg trays and ~70% of farms did not clean outside egg trays with... | 923 | 255639859 | 0 | 16 |
reported by case farms but not by control farms were selected for the univariate analysis. Two factors (farm size and source of birds) were subjected to further analysis as they were significantly associated with the MD outbreak (p > 0.1) ( Table-3). In the final multivariable model, no variable was identified as signi... | 924 | 255639859 | 0 | 16 |
recorded over 20 years. Moreover, the layer and egg industry of Thailand mostly consists of small commercial farms, which have inaccurate information on production and veterinary records, making quantitative analysis even more challenging. Marek's disease outbreaks have been investigated in other countries, including E... | 925 | 255639859 | 0 | 16 |
field [8,27]. The value chain diagram indicated that small-scale farms had no power to negotiate the price of DOCs due to their small purchases, forcing them to buy some DOCs from large farms. Thus, large farms, especially those that ordered DOCs and pullets with risk of MDV infection from other areas, were identified ... | 926 | 255639859 | 0 | 16 |
of increased demand and transportation of DOCs (peak in June) and pullets (peak in October) to the area. From the previous studies, the mortality rate of MD is around 10%-15% [9,21], which is similar to the mortality rate of 10% recorded in this study. Clinical signs of infected birds are most commonly seen between 12 ... | 927 | 255639859 | 0 | 16 |
from unknown suppliers without following the appropriate quality assurance procedures. One of those new suppliers, Company A, was associated with the disease (p < 0.1). When conducting the investigation, Company A started as a feed company, but to meet the high demand of farmers during that period, the company turned i... | 928 | 255639859 | 0 | 16 |
of this loss came from the opportunity cost due to removed birds, which led to egg reduction and interrupted the production cycle. This type of cost is usually neglected and is hidden from most farmers. The economic loss was communicated to farmers and local officers, leading to increased awareness about MD and the imp... | 929 | 255639859 | 0 | 16 |
risk practices, and economic figures. From the outbreak investigation, potential risk factors for the occurrence of MD outbreaks were identified, namely, large farm size and purchasing birds from an inexperienced company that did not vaccinate against MD. Finally, the estimation of economic losses was very important in... | 930 | 255639859 | 0 | 16 |
An unusual case of repeated venous air embolism during awake bilateral deep brain stimulation surgery Venous air embolism (VAE) is the entrainment of air either from a surgical site or from the environment into the venous or arterial vasculature, which can subsequently cause systemic effects. Many cases are subclinical... | 931 | 56047544 | 0 | 16 |
the treatment of movement disorders such as Parkinson's disease (PD), essential tremors, dystonia and certain psychiatric disorders and commonly performed in awake and spontaneous ventilation patients. 2,3 There have been a few reported cases of VAE in DBS surgery that raise a concern for extra monitoring and prompt ma... | 932 | 56047544 | 0 | 16 |
given supplemental 3 L/ min of oxygen via a nasal prong, which also connected to capnography for end tidal carbon dioxide (E T CO 2 ) monitoring. Peripheral venous access was established on both forearms. Anaesthesia management was planned with a monitored anaesthesia care technique using intravenous (IV) dexmedetomidi... | 933 | 56047544 | 0 | 16 |
dropped subsequently to 50% and then the patient became apnoeic. E T CO 2 was initially reduced to 25 mm Hg and the waveform was flat during apnoea. Heart rate was bradycardic until 39 beats/min but then reverted spontaneously to 70-80 beats/min without administration of any medications. BP was maintained at 130/50 mm ... | 934 | 56047544 | 0 | 16 |
100/60-130/85 mm Hg. We started him on amiodarone infusion for the AF. He was subsequently stable and extubated 20 min after the heart rate reverted to sinus rhythm. The surgery for the insertion of DBS on the left side was postponed and he was closely observed in the neurosurgical intensive care unit (ICU) for one day... | 935 | 56047544 | 0 | 16 |
pressure which is favourable for air entrainment into diploic venous channels of the porous skull bone or through the breached sinus system. 8 There are clear differences in diagnosing the probability of VAE in awake patients and in fully anaesthetised patients. In awake patients, clinical symptoms are more important f... | 936 | 56047544 | 0 | 16 |
catheter and transcranial Doppler. 1 End tidal nitrogen and ETCO 2 are classified under moderate sensitivity monitoring whereas the rest of monitoring such as oxygen saturation, oesophageal stethoscope and ECG are low in sensitivity. 1 The presentation of acute cough is also an important predictor of VAE during DBS sur... | 937 | 56047544 | 0 | 16 |
between the signs of VAE and the signs of light anaesthesia. Most of the time, the detection of VAE during general anaesthesia is based more on the changes in monitoring parameters in a high-risk surgery group. In our patient, the presentation was unique because it happened during both sides of the burr hole and electr... | 938 | 56047544 | 0 | 16 |
of crepitations and rhonchi on auscultation also ruled out the other respiratory causes. Therefore, based on the nature of the surgery and clinical presentation, the diagnosis of VAE was the most likely in our case. Prompt recognition and management are critical to avoid further associated complications, and respirator... | 939 | 56047544 | 0 | 16 |
Predicting return to work among patients with colorectal cancer Background The increase in prevalence of colorectal cancer among young patients coupled with an older retirement age in developed countries means that more patients are being diagnosed with colorectal cancer while still at work. The aim of this study was t... | 940 | 204908249 | 0 | 16 |
returning to work, and to identify and modify barriers that could facilitate this. Introduction Improvements in colorectal cancer management have led to more patients being diagnosed at an early stage, with improved survival 1 -7 . As a result, more patients with colorectal cancer will resume normal life after treatmen... | 941 | 204908249 | 0 | 16 |
for patients to return to work 19,20 . The aim of this study was to develop and internally validate prediction models for return to work by 1 and 2 years after the start of the sick leave among patients with colorectal cancer. Methods This was a retrospective registry-based cohort study. Data were extracted from the na... | 942 | 204908249 | 0 | 16 |
first 2 years of sick leave, the occupational health physician reviews the patient every 6 weeks to monitor recovery and potential for return to work, and to give advice. Employers are obliged to pay at least 70 per cent of the salary of the sick employee during these 2 years. After 2 years, if a return to work has not... | 943 | 204908249 | 0 | 16 |
h but more than 12 h per week), flexible) 38 , type of employment (permanent, temporary contract), company size (micro (fewer than 10 employees), small (11-50 employees), medium (51-250 employees), large (251 or more employees)) 39 , relationship with employer (bad, good) and the trajectory of the return to work (direc... | 944 | 204908249 | 0 | 16 |
The variable age was tested for linearity by means of spline curves and was subsequently considered as a continuous variable in the analysis 40 . All candidate predictors were analysed in a separate univariable analysis. Then, multivariable logistic regression modelling with backward selection of variables with P ≤ 0⋅1... | 945 | 204908249 | 0 | 16 |
as a shrinkage factor to correct the regression coefficients of the original model, and report the optimism-corrected AUC and Nagelkerke's R 2 value 42 . Results Some 317 patients with colorectal cancer were identified in the registry, 175 patients with colonic and 142 with rectal cancer. Patient characteristics are su... | 946 | 204908249 | 0 | 16 |
trajectory of the return predicted not returning to work by 2 years. Prediction model for return to work by 1 year Multivariable analysis identified the following variables as independent predictors of not returning to work by 1 year: presence of metastases, adjuvant therapy, stoma, emotional distress and postoperative... | 947 | 204908249 | 0 | 16 |
model are shown in Figs 2b and 3b respectively. Calculation of the probability of return to work by 2 years for a fictitious patient in shown in Appendix S1 (supporting information). Discussion Return to work after cancer treatment can be considered a surrogate marker of recovery in general. The ability to work is rate... | 948 | 204908249 | 0 | 16 |
year, which is lower than reported previously. This may be a result of different definitions of return to work 26 -30 . Alternatively, the lower rate of return to work by 1 year may be explained by differences in sick-leave regulations between countries. Patients may be less motivated to return to work when state-funde... | 949 | 204908249 | 0 | 16 |
and were therefore not included in the analysis. In addition, for some candidate predictors it was assumed that no reference in the occupational health medical report meant that this factor was not present. The occupational health physicians involved in this study indicated that it is routine practice not to specifical... | 950 | 204908249 | 0 | 16 |
Estimation of serum immunoglobulin G and immunoglobulin A levels in oral submucous fibrosis patients Background: Oral submucous fibrosis (OSMF) is a disabling, chronic, insidious potentially malignant condition of the oral cavity seen predominantly in the Indian subcontinent. Due to the idiopathic nature and various im... | 951 | 248283940 | 0 | 16 |
suggested that there is an alteration in serum immunoglobulin levels in OSMF patients as compared to the control group. INTRODUCTION Oral submucous fibrosis (OSMF) was first described in 1952 by Schwartz who named it as "Atrophia idiopathica (tropicum) mucosum oris." Later, in 1953, it was first described in India. [1]... | 952 | 248283940 | 0 | 16 |
immune response in OSMF by estimation of serum immunoglobulin G (IgG) and immunoglobulin A (IgA) levels in different clinical stages of the disease. MATERIALS AND METHODS The present study comprised two groups (OSMF group and control group) of 25 patients each of either sex. The diagnosis of OSMF was made based on clin... | 953 | 248283940 | 0 | 16 |
used for immunological investigation. Serum IgG and IgA were quantitated by using a diagnostic kit for NEPHELOMETRY: AGAPPE MISPA i2 [ Figure 2] for estimation of immunoglobulin IgG and IgA by Nephlometry method. The reagents used for IgG are R1-Glycine Buffer Solution and R2-Latex suspension coated with denatured huma... | 954 | 248283940 | 0 | 16 |
showed no significant pattern of change and also the alterations were negligible [ Table 1]. Statistically, Spearman's rank correlation of serum IgG and IgA levels with age groups of OSMF patients showed no correlation between age of the patient and serum IgG and IgA levels (P > 0.05). The mean serum IgG levels in fema... | 955 | 248283940 | 0 | 16 |
form in the decreasing order. The mean serum IgA levels were highest among patients with areca nut alone habit and lowest in patients with areca nut and gutkha habit. Statistically, the Eta coefficient showed a weak correlation of habit patterns with serum IgG and IgA levels [ Table 4]. DISCUSSION OSMF is a localized d... | 956 | 248283940 | 0 | 16 |
of occurrence of OSMF cases in the second and third decades of life which is in accordance with the present study. [8,9,11] On correlating the serum IgG and IgA levels with various age groups in OSMF patients, the serum IgG levels were found to be increasing gradually with the increase in age of the OSMF patients, wher... | 957 | 248283940 | 0 | 16 |
levels with gender. In the present study, all OSMF cases had a habit of chewing areca nut in one or the other form. Grade I cases showed more habitual for areca nut with gutkha while Grade IV cases showed more liking for mixed habits including smoking. Furthermore, male patients were more inclined toward mixed habits w... | 958 | 248283940 | 0 | 16 |
(12.63 ± 0.87 g/l), we found the levels to be marginally increased in OSMF cases which was statically insignificant. This was in accordance with previous studies that have reported no change or statically insignificant rise in levels of serum IgG in OSMF cases. [7,17] However few studies have reported a statistically s... | 959 | 248283940 | 0 | 16 |
Craniofacial morphology in down syndrome: a systematic review and meta-analysis The aim of this study was to evaluate the craniofacial cephalometric characteristics of individuals with Down syndrome (DS), comparing them with healthy subjects. An electronic search was made in Pubmed, Embase, Lilacs, Scopus, Medline and ... | 960 | 226989032 | 0 | 16 |
third of the face flattened and a reduced anterior and posterior facial heights. Methodological quality assessment. The methodological quality of the articles selected was assessed using the Newcastle-Ottawa Quality Assessment scale (NOS) 18 by two examiners working together (A.V and A.L) and a third examiner (C.S) wor... | 961 | 226989032 | 0 | 16 |
(SBa, mm), total cranial base length (BaN, mm), posterior cranial base inclination (SNBa, °), sagittal position of subspinale relative to cranial base (SNA, °), effective length of the maxilla (CoA, mm), sagittal position of supramentale relative to cranial base (SNB, °), relative position of maxilla and mandible to ea... | 962 | 226989032 | 0 | 16 |
difference) was calculated, as well as the 95% confidence interval 19 . Heterogeneity of the effect sizes was checked with the Q statistic and I 2 index. A statistically significant result for the Q statistic (p < 0.05) indicated the presence of heterogeneity. In addition, heterogeneity I 2 indices around 25%, 50%, and... | 963 | 226989032 | 0 | 16 |
they were excluded from the meta-analysis. Reliability of data extraction process. The degree of inter-examiner agreement was high. For all quantitative variables, except for the item "number of controls, " an intra-class correlation coefficient of one was obtained. Initially the intra-class correlation coefficient for... | 964 | 226989032 | 0 | 16 |
assessed by means of the measurements SN 22 23,25,27 . Anteroposterior relation between maxilla and mandible was determined by means of the ANB angle 23,25,27,28 ; anterior face height by NMe 23,27,28 ; and posterior face height by means of SGo 23,27,28 . Table 4, a total of five studies were found to report outcomes. ... | 965 | 226989032 | 0 | 16 |
significant differences were found between the average effect sizes of the two age range categories for outcomes SNBa (p = 0.039); SNB (p = 0.004) and NMe (p = 0.035). Regarding Table 2. Methodological quality for all 9 case control studies identified by the search strategy, assessed using the Newcastle-Ottawa-Scale. a... | 966 | 226989032 | 0 | 16 |
cephalometric characteristics of individuals with DS differ from those of the general population. It was decided not to limit the literature search by language or date of publication in order not to miss any article that might provide information relevant to the work's hypothesis; as a result, articles in three languag... | 967 | 226989032 | 0 | 16 |
growth of the cranial base is considered rather autonomous, as compared to the cranial vault, because of that, we think that the smaller brain size of DS individuals should not be considered the main cause or the only cause of the short anterior cranial base of these patients. Rather both facts could be the effect www.... | 968 | 226989032 | 0 | 16 |
At the same time, the cranial base angle (SNBa) was significantly larger in DS than control subjects. It has been suggested that delay in intra-sphenoidal synchondrosis fusion in postnatal life is essential to the cranial base's flattening mechanism. Radiographic data obtained from individuals with DS show a delay in f... | 969 | 226989032 | 0 | 16 |
erroneous cephalometric interpretation. For this reason, Jesuino and Valladares suggest that in these cases cephalometric measurements should take the Frankfort plane as reference 27 . The reduced anterior cranial base in DS can make the SNA similar to that of control subjects due to a geometric effect, even though the... | 970 | 226989032 | 0 | 16 |
determine the anteroposterior position of the mandible correctly, and to reach clear conclusions regarding the size of the mandible. Meanwhile, in the 6-11 year age range, SNB angle values were lower in DS subjects than controls, while in the 5-22 year range it was larger in DS groups. This could be a result of the fac... | 971 | 226989032 | 0 | 16 |
anterior open bite among individuals with DS, although they reported a low level of evidence for an association between DS and anterior open bite 38 . Although the present work suffered several limitations, it was possible to reject the hypothesis that there would be no differences in craniofacial characteristics betwe... | 972 | 226989032 | 0 | 16 |
In the Name of Transparency: Organizing European pharmaceutical markets through struggles over transparency devices The controversies surrounding the heavily redacted contracts between the European Commission and Covid-19 vaccine producers have highlighted ‘transparency’ as a hotly debated concept in the pharmaceutical... | 973 | 258166754 | 0 | 16 |
to reduce the spaces of opacity in which high prices for medicines were said to proliferate (Shaw & Mestre-Ferrandiz, 2020).Yet, while states, corporations and civil society all agreed on the benefits of 'more transparency', its very definition was a contested one.Shortly after the WHA, a pharmaceutical spokesperson pu... | 974 | 258166754 | 0 | 16 |
role that these devices play in the organization of markets.Our study contributes to research that moves beyond normative views of market transparency (Roscoe, 2022;Roscoe & Willman, 2021) by analysing the struggles that occur around competing visions of transparency and, crucially, by tracing how these struggles shape... | 975 | 258166754 | 0 | 16 |
Transparency and its contestations The topic of transparency has presented a lively field of research in organization studies in the past decade, as studies have questioned a normative understanding of transparency in organizations (Fenster, 2015;Splitter, Dobusch, von Krogh, Whittington, & Walgenbach, 2023).Critical a... | 976 | 258166754 | 0 | 16 |
and Weiskopf (2021) for instance study the Chinese social credit system, where different transparency matrices -law, discipline, security and care -are used to mobilize different mediating technologies.Hansen, Christensen and Flyverbom (2015) contemplate how so-called disclosure devices -due diligence, rankings and big... | 977 | 258166754 | 0 | 16 |
economic settlements.Post-political governance seeks to establish jointly beneficial solutions and 'win-win' relationships but often occludes the hegemonic character of these agreements (Garsten & De Montoya, 2008).Leaning on Chantal Mouffe's (2005) work, Saifer and Dacin (2022) for instance reflect on how data discour... | 978 | 258166754 | 0 | 16 |
'enabling' tool -to restrict their own influence in market affairs and to simultaneously hold market actors accountable (Grossman, Luque, & Muniesa, 2008).Yet, far from being a natural corollary of a well-designed market, transparency has to be carefully worked into it -even in those markets said to be 'liquid' (Roscoe... | 979 | 258166754 | 0 | 16 |
an array of actors and instrumented through diverse socio-material arrangements. The strong focus on devices in this literature is helpful in tracing the concrete organizational efforts that unfold from shifting definitions of transparency -an attention that is often missing from transparency studies and that, as we ar... | 980 | 258166754 | 0 | 16 |
over definitions of transparency.We adopt a pragmatic understanding of these devices as those parts of a market's organization that are explicitly embedded in the struggles around transparency by market actors -either because they are labelled as 'transparency' instruments by actors themselves or because they are being... | 981 | 258166754 | 0 | 16 |
politics to address the following question: How do struggles over transparency shape markets and their devices?A focus on markets allows us to bring an explicitly political perspective to the constitutive transparency perspective, which includes tracing how market transparency has been used as a tool of post-political ... | 982 | 258166754 | 0 | 16 |
today.For the government perspective, we investigated the archives of the French Ministry of Health, from 1989 to 1999, consulting the approximately 50 documents related to the regulatory framework produced by the branch of the Health Ministry in charge of pharmaceuticals (documents past 1999 were embargoed).We triangu... | 983 | 258166754 | 0 | 16 |
any shifts back to earlier debates, regulatory drafts and public consultations.In a second step, we analysed regulatory and policy shifts that more broadly affected how transparency was organized in our focal market, and we drew on data across our sources to establish the histories and chronologies of these shifts (Lan... | 984 | 258166754 | 0 | 16 |
for the dynamics traced in our analysis, we use the shorthand 'A' (plus year and number) for quoted archival sources listed in Table 1; 'E' designates observational data gathered from the events listed in Table 2; and the letter 'I' signals interview data (Table 3). Findings: Struggles Over Transparency Devices Shape M... | 985 | 258166754 | 0 | 16 |
to be 'unsustainable'.The heads of European pharmaceutical agencies involved in reimbursing medicines have expressed concern regarding their weakness in negotiations over pharmaceutical contracts (EPHA, 2020).National payers assert that they are not able to negotiate on an equal footing with large pharmaceutical compan... | 986 | 258166754 | 0 | 16 |
of opacity this vision was arguably creating and its detrimental consequences for the industry.Sketching out three main European markets of the time -France, the UK and Germany -we describe the transparency devices in place during this period and how they were contested. The domination of European pharmaceutical market... | 987 | 258166754 | 0 | 16 |
.[. . .]In most cases, we would end up in the office of the Prime Minister's health advisor, who was arbitrating between us. In the UK, there was no 'price grid', but pharmaceutical companies were constrained by sectoral regulations that limited their margins and levels of profit (Gross, Ratner, Perez, & Glavin, 1994).... | 988 | 258166754 | 0 | 16 |
the organization of pharmaceutical markets.Regarding the evaluation of medicines, they required negotiators to engage in intense accounting activities behind each drug and company, a framework that came to be known as the cost-based system.As Chauveau (1999, p. 673) explains for France, price setting for a given pharma... | 989 | 258166754 | 0 | 16 |
for member-states 'to abandon their broad set of price and profit control instruments' (A.3 1992, p. 13).These calls made it clear that manufacturers were not simply asking for 'less' transparency -what they had in mind was a very different kind of transparency, one that would give corporations deeper insights into sta... | 990 | 258166754 | 0 | 16 |
transparency was accused of creating opacity around states' price determination practices, leaving too much scope for political considerations beyond cost control to enter decisionmaking processes. Period II -Mobilizing transparency for pharmaceutical corporations (ca. 1990 to 2010) From around 1990 to 2010, a new visi... | 991 | 258166754 | 0 | 16 |
it focused on transparency of payer processes: 'the G10 believes that much could be done to improve the transparency of national decision-making. . .Greater transparency would allow industry and other regulators a clearer understanding of the criteria used and lead to greater consistency of decisions' (A.10 2002, p. 13... | 992 | 258166754 | 0 | 16 |
allowing for legal action). The devising of these rules deeply affected the organization of European pharmaceutical markets.First, they resulted in the adoption of a new system for evaluating pharmaceuticals.In period I, manufacturers often suspected that medical evaluations were used as an instrument to control price ... | 993 | 258166754 | 0 | 16 |
no longer open to scrutiny, with one French pharmaceutical lobbyist summarizing this move as finally being 'freed from an authoritarian administrative system' (A.5 1994, p. 22).Bourgeron and Geiger (2022a) observe that the new market arrangements around value-based pricing had the opposite effect on generic pharmaceuti... | 994 | 258166754 | 0 | 16 |
payers accused this new system of making prices themselves opaque.Under the unified European market, the negotiation of prices for new medicines became progressively framed by the outcome of price negotiation in comparable countries -a process known as 'external reference pricing'.In this system, the price and medical ... | 995 | 258166754 | 0 | 16 |
competitiveness, to the detriment of public health'.They promoted a vision of transparency that would reassert 'the authority of member states. . . on their reimbursement list, and also on pricing' (A.14 2012, p. 1-3).States successfully blocked the proposal, illustrating how contested the prevailing vision of transpar... | 996 | 258166754 | 0 | 16 |
however, has come to be criticized in its turn at the end of the period, with civil society arguing for a need to go beyond transparency for state coalitions. Coalescing to redefine transparency.By the early 2010s, faced with escalating pharmaceutical prices that had reached six-figure sums per patient (Bourgeron & Gei... | 997 | 258166754 | 0 | 16 |
the entire value chain. . . to the benefit of all stakeholders', according to the former head of the Italian agency Aifa (E.15).Or, as stated in the Oslo Medicines Initiative: 'transparency could be used to build trust between stakeholders, thereby enhancing negotiations and supporting access' (Larsen, 2022, p. 33). Th... | 998 | 258166754 | 0 | 16 |
and negotiate prices together.The BeNeLuxA group, gathering Belgium, Netherlands, Luxemburg, Austria and Ireland, was founded in 2015 with the explicit goal to 'improve transparency on pricing between the collaborating countries' (BeNeLuxA, 2018, 4;I.8).The Valletta Declaration Group was created two years later around ... | 999 | 258166754 | 0 | 16 |
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