Search Results (178)

Background: The quality of decision-making processes is increasingly recognized as critical to public trust and policy sustainability. Objectives: This narrative review aims to identify and describe process-focused decision support models (DSMs) applied in pharmaceutical policy, and to examine their potential contributions to improving procedural quality in decisions related to pricing, reimbursement, and access to medicines. Methods: Relevant peer-reviewed and gray literature published between 2000 and 2025 was considered, drawing from key databases (e.g., PubMed and Scopus) and international policy reports (e.g., WHO, ISPOR, and HTA agencies). Studies were included if they provided insights into DSMs addressing at least one dimension of decision process quality. Results: Findings are synthesized narratively and organized by tool type, application context, and key quality dimensions. Frequently referenced tools included the Quality of Decision-Making Orientation Scheme (QoDoS), WHO-INTEGRATE, and AGREE II. QoDoS emerged as the only tool applied across regulatory, HTA, and industry settings, evaluating both individual- and organizational-level practices. WHO-INTEGRATE highlighted equity and legitimacy considerations but lacked a structured format. Overall, most tools demonstrated benefits in promoting internal consistency, transparency, and stakeholder engagement; however, their adoption remains limited, especially in low- and middle-income countries. Conclusions: Process-focused DSMs offer promising avenues for enhancing transparency, consistency, and legitimacy in pharmaceutical policy. Further exploration is needed to standardize evaluation approaches and expand the use of DSMs in diverse health systems. Full article

As a classical statistical method, multiple regression is widely used for forecasting tasks in power, medicine, finance, and other fields. The rise of machine learning has led to the adoption of neural networks, particularly Long Short-Term Memory (LSTM) models, for handling complex forecasting problems, owing to their strong ability to capture temporal dependencies in sequential data. Nevertheless, the performance of LSTM models is highly sensitive to hyperparameter configuration. Traditional manual tuning methods suffer from inefficiency, excessive reliance on expert experience, and poor generalization. Aiming to address the challenges of complex hyperparameter spaces and the limitations of manual adjustment, an enhanced sparrow search algorithm (ISSA) with adaptive parameter configuration was developed for LSTM-based multivariate regression frameworks, where systematic optimization of hidden layer dimensionality, learning rate scheduling, and iterative training thresholds enhances its model generalization capability. In terms of SSA improvement, first, the population is initialized by the reverse learning strategy to increase the diversity of the population. Second, the mechanism for updating the positions of producer sparrows is improved, and different update formulas are selected based on the sizes of random numbers to avoid convergence to the origin and improve search flexibility. Then, the step factor is dynamically adjusted to improve the accuracy of the solution. To improve the algorithm’s global search capability and escape local optima, the sparrow search algorithm’s position update mechanism integrates Lévy flight for detection and early warning. Experimental evaluations using benchmark functions from the CEC2005 test set demonstrated that the ISSA outperforms PSO, the SSA, and other algorithms in optimization performance. Further validation with power load and real estate datasets revealed that the ISSA-LSTM model achieves superior prediction accuracy compared to existing approaches, achieving an RMSE of 83.102 and an $R^2$ of 0.550 during electric load forecasting and an RMSE of 18.822 and an $R^2$ of 0.522 during real estate price prediction. Future research will explore the integration of the ISSA with alternative neural architectures such as GRUs and Transformers to assess its flexibility and effectiveness across different sequence modeling paradigms. Full article

For the self-medication of nasal congestion following a common cold, decongestant nasal sprays can be recommended according to the medicine guidelines. In Germany, these are only available in community pharmacies (CPs) with free pricing. The aim was to analyze the medication recommendation, counseling, and pricing. A covert simulated patient study, internationally recognized as the “gold standard”, was conducted in all CPs of two medium-sized cities in north-eastern Germany. Each CP was visited twice (86 visits) with the identical scenario by one female and one male simulated patient. At the beginning, they asked for a nasal spray and, when asked, stated that they had had nasal congestion for three days. Slightly more than half (54.7%, 47/86) of the recommended nasal sprays were free of preservatives. The median counseling score was 2.0 out of 8 points, with a significantly higher score observed for the female SP (p = 0.004). Information on the maximum intake duration of five days recommended in the German pharmacy guideline was not provided during any visits. The prices varied in total from EUR 1.95 to EUR 6.22. Therefore, measures by the legislator and the chambers of pharmacists are necessary to sustainably improve the medication recommendation, the counseling, and the price transparency. Full article

Cancers are problematic for health systems globally, including in Antigua and Barbuda, where understanding the changing extent of common cancers is key to implementing effective prevention and control strategies. This study aimed to assess the relationship between treatment rates and drug treatment costs along with characteristics affecting these costs for patients with female breast, cervical, colorectal and prostate cancers in Antigua and Barbuda from 2017 to 2021. A retrospective observational study design was used. Estimates of age-standardized treatment rates and drug treatment costs were determined using direct standardization and a micro-costing approach, respectively. Linear regression was used to evaluate the relationship between age-standardized treatment rates and drug treatment costs. Model independent variables were assessed for multicollinearity and residuals examined for variance and normality. With a sum of 242 cases identified for this study, each cancer type showed evidence of strong positive correlations and significant associations between treatment costs and age-standardized treatment rates. The mean cost (USD) of drug treatment was highest for female breast (USD 25,009.63) and colorectal (USD 13,317.16) cancers and lowest for prostate (USD 12,528.10) and cervical (USD 5121.41) cancers, with several variables showing significance in the respective final models. An association existed between age-standardized treatment rates and drug treatment costs for the cancers studied. These results offer a basis for encouraging strategies in obtaining affordably priced cancer medicines in Antigua and Barbuda. Full article

Functional foods are products that have clinically evidenced health benefits for consumers due to one or more of their ingredients. While research indicates that consumers are highly interested in these products and are often willing to pay premium prices to buy them, stories of market failure are frequent for the specific category. Hence, a critical question is what determines consumers’ willingness to purchase functional food products. A hypothesis confirmed by many studies is that health concerns are positively associated with purchasing intentions. Nevertheless, other factors may also positively or negatively affect consumers’ willingness to buy functional foods. Our work examines this contention by focusing on a novel functional food product: yogurt enriched with sea buckthorn. The product, which is developing in the framework of an ongoing project, is expected to combine the health benefits of yogurt with the medicinal properties of sea buckthorn. Full article

Isometric training is a method focused on muscle strengthening without joint movement and has gained attention in recent years due to its applicability in rehabilitation and sports medicine. However, no comprehensive bibliometric analysis focused exclusively on adult populations has been performed. This study aimed to analyze the scientific production related to isometric training in adults; identify prominent authors, journals, and thematic trends; and evaluate the evolution of interest in this field over time. A bibliometric review was performed using the Web of Science Core Collection (SCI-E, SSCI, and ESCI). A specific search strategy was applied to identify articles and reviews focused on isometric training in adult populations. A total of 238 records met the inclusion criteria. Data were analyzed using Excel 2016 and VOSviewer software1.6.20. Bibliometric indicators such as Price’s Law, Bradford’s Law, Lotka’s Law, h-index, and co-occurrence and co-authorship network analysis were applied. The results showed a steady increase in publications in the last decade, highlighting the categories of Sports Science, Physiology, and Cardiovascular. The Journal of Applied Physiology was the most frequent source, and Springer Nature was the most prolific publisher. The h-index identified 21 highly cited papers, and Lotka’s Law confirmed the existence of a small group of prolific authors. VOSviewer analysis revealed clear thematic clusters, mainly around blood pressure regulation, rehabilitation, and aging. International collaboration was evident, with the United States, Canada, and the United Kingdom leading the co-authorship networks. Scientific interest in isometric training for adult populations is growing, particularly in relation to cardiovascular health and rehabilitation. Despite this, gaps remain in terms of methodological consistency and standardized protocols. Addressing these issues could improve the applicability and scientific impact of this training modality. Full article

Alcoholic beverages play a significant role in social engagement worldwide. Excessive alcohol causes a variety of health complications. Alcohol-induced liver disease (ALD) is responsible for the bulk of linked fatalities. The activation of immune mechanisms has a crucial role in developing ALD. No effective medication promotes liver function, shields the liver from harm, or aids in hepatic cell regeneration. Alcohol withdrawal is one of the most beneficial therapies for ALD patients, which improves the patient’s chances of survival. There is a crucial demand for safe and reasonably priced approaches to treating it. Exploring naturally derived phytochemicals has been a fascinating path, and it has drawn attention in recent years to modulators of inflammatory pathways for the prevention and management of ALD. In this review, we have discussed the roles of various immune mechanisms in ALD, highlighting the importance of intestinal barrier integrity and gut microbiota, as well as the roles of immune cells and hepatic inflammation, and other pathways, including cGAS-STING, NLRP3, MAPK, JAK-STAT, and NF-kB. Further, this review also outlines the possible role of phytochemicals in targeting these inflammatory pathways to safeguard the liver from alcohol-induced injury. We highlighted that targeting immunological mechanisms using phytochemicals or herbal medicine may find a place to counteract ALD. Preclinical in vitro and in vivo investigations have shown promising results; nonetheless, more extensive work is required to properly understand these compounds’ mechanisms of action. Clinical investigations are very crucial in transferring laboratory knowledge into effective patient therapy. Full article

Herbal medicines have significant industrial value in East Asia. Zizyphus jujuba Mill. var. spinosa, used in Korea for treating insomnia, is often confused with Zizyphus mauritiana Lam., which has unverified medicinal properties yet is sold at premium prices. This misclassification undermines consumer trust and poses health risks. This study proposes a deep learning-based classification system trained on RGB-GE data, combining grayscale and edge-detected images with RGB inputs to enhance feature extraction while reducing color-dependency. Our method achieves superior generalization while maintaining cost-effectiveness. The system incorporates Grad-CAM for model interpretation and reliability. By comparing accuracy and speed across basicCNN, DenseNet, and InceptionV3 models, we identified an optimal solution for on-site herbal medicine classification, achieving 98.36% accuracy with basicCNN, ensuring reliable quality control. Full article

Hippophae (sea buckthorn) is a plant valued for its berries in food manufacturing and medicinal properties. Despite growing research on its benefits, consumer perceptions of sea buckthorn-based products remain underexplored. This study examines Greek consumers’ attitudes toward cereal bars enriched with sea buckthorn, developed within a project focused on high-nutritional-value foods. Key factors include awareness, taste, safety, health benefits, trust, convenience, price, appearance, quality certification, environmental friendliness, and support for small-scale farmers. Results show moderate willingness to buy due to perceived health benefits and sustainability, but marketing should address sensory profile and trust to build a robust market. Full article

The animal kingdom, particularly reptiles, is widely recognized as a valuable source of peptides and proteins with applications in medicine, the pharmaceutical industry and, more recently, the cosmetic industry. This prompted an investigation into the prevalence of cosmetic products utilizing synthetic peptides, with a specific focus on viper venom. A major objective of our study was a comparative analysis between natural venom-derived peptides and synthetic analogues, which could provide valuable insights into the market impact. The identification and inclusion of these products were based on their listings according to the International Nomenclature of Cosmetic Ingredients (INCI), alongside a review of the current literature and the recognition of relevant studies aimed at evaluating the composition of viper venom. Additionally, cosmetics were identified through online media using specific keywords such as “viper venom”, “snake venom”, “snake”, “SYN^®-AKE”, “analogues of snake venom” or “synthetic snake venom”, followed by a comparative analysis of the products identified. The study provided an extensive background considering the market segmentation of viper venom-based and synthetic peptide-based cosmetics, including 245 cosmetics (70 manufacturers), also including the classification into Mass-Market and Premium-Market segments, which adds practical value. In 81% of the total analyzed products, the synthetic analogue was present, SYN^®-AKE (INCI Dipeptide Diaminobutyroyl Benzylamide Diacetate (and) Glycerin (and) Aqua), while 13% contained snake venom or viper venom. The high percentage of cosmetics categorized under the Mass-Market segment could be attributed to the use of synthetic peptides, given the high cost of natural viper venom as an anti-ageing ingredient, a price likely reflected in the final cosmetic product. In terms of product category, skin care cosmetics made up the largest share, followed by body care products, typically claiming anti-ageing and moisturizing properties. Full article

Regarded as a panacea in non-traditional medicine, Spirulina (“Arthrospira platensis”) refers to cyanobacteria that are highly consumed due to their mineral and bioactive compounds. Despite its wide popularity and availability, Spirulina is often present on the market as an insufficiently regulated dietary supplement with scarce quality control and has high batch-to-batch variability. The present study aims to provide the first comprehensive survey of the Spirulina commercialized on the Romanian market. Therefore, a highly diverse sample set, including an in-house cultivated sample, was analyzed and compared in regard to the ¹³C isotopic signature and the elemental profile of twenty-three elements, including macro-nutrients (Na, Mg, Ca, and K), essential trace elements (e.g., Fe, Zn, Co, and Mn), and possible toxic contaminants (e.g., As, Cd, Cr, and Pb). Results confirmed the potency of Spirulina as a proper mineral supplement source. The in-depth analysis performed in the present work takes into account several critical factors, like formulation, packaging type and material, geographical origin, and labeled growing system, in order to assess whether these marketing strategies are supported. Additionally, the statistical relationships among the price, isotope, and elemental determinations were assessed by Pearson correlation coefficients and subsequently discussed in regard to the biochemical and physiological processes. Full article

Background/Objectives: Physical activity allows the enjoyment of personal health benefits in those who practice it, including the possibility of modifying behavioral risk factors such as tobacco and alcohol consumption. These risk factors are responsible for the development of non-communicable diseases, which are preventable and controllable. The scientific field on this object of study has grown in recent years. The main objective of this study was to perform a scientific mapping to explore the trend of annual publications, and to analyze and identify the thematic categories, the authors, countries and journals with the highest number of papers, the most referenced papers and authors, and the most used keywords in research related to physical activity and tobacco and/or alcohol consumption. Methods: Through a bibliometric analysis based on traditional bibliometric laws on the scientific documentation related to the subject and indexed in the Main Collection of the Web of Science. The DeSolla Price Law was used to analyze the trend of annual publications, using the coefficient of determination R². Lotka’s law was applied to identify prolific authors, Bradford’s law to highlight the most frequent publication sources, the h-index to identify the most cited articles and Zipf’s law to highlight the keywords most used in research. Results: A total of 538 documents were analyzed. The trend followed by annual publications is in an exponential growth phase. Adrian Taylor and Michael Ussher were identified as prolific authors. USA and Preventive Medicine were the country and journal with the highest number of publications. The most frequently used words were physical activity, smoking, exercise, alcohol, obesity, and smoking cessation. Conclusions: This bibliometric review identified an exponential growth from 1994 to date of research related to physical activity and tobacco and/or alcohol consumption. It allowed us to identify trends and guide the development of future research in these or new related areas. Full article

Over the past decade, an increasing number of oncology medicines with indications for multiple cancer types have been delivering benefits to patients. To ensure these products reach patients, pricing and reimbursement systems have had to adapt to address the value assessment, time-to-access, affordability, and budget uncertainty challenges this creates. Multi-year multi-indication (MYMI) agreements are made between payers and manufacturers and aim to ensure that patients have access to effective treatments for multiple conditions over time; this includes future indications of the treatment. MYMI agreements were first introduced as a solution in several European countries in 2017, offering a range of potential benefits. MYMI agreements have since demonstrated evidence of success in mitigating many of the challenges associated with assessing and reimbursing multi-indication products, time-to-patient access, and budget impact. The purpose of this article is to discuss the recent progress made with MYMI implementation across countries and provide a view on whether it is delivering for patients, healthcare systems, and innovators. We find that MYMI is not a one-size-fits-all solution but a model that needs to be adapted to the unique needs and characteristics of different healthcare systems. The intended benefits of MYMI to patients (speed and breadth of access to new indications) appear to have been realised in practice in some countries but not all. However, the administrative burden associated with MYMI implementation in some countries risks jeopardising the intended efficiency benefits. Payers and policymakers can also benefit from improved budget predictability and sustainability. Full article

Lincomycin belongs to the antibiotics commonly used in veterinary medicine. Its residues are easily spread in the environment because of its physicochemical properties, including resistance to biodegradation and good solubility in water. One of the effective methods for the removal of lincomycin from wastewater is the photocatalytic process, but it is not widely used due to the price of photocatalysts. The aim of this work was to compare the photocatalytic efficiency and the mechanism of lincomycin degradation initiated by UVa radiation in the presence of TiO₂-P25 and ZnO, as well as in the presence of industrial pigments commonly used in construction and containing TiO₂. Lincomycin was found to undergo efficient photocatalytic degradation in the presence of a commercial TiO₂-P25 photocatalyst, industrial pigments containing only anatase, and in the presence of ZnO. On the contrary, industrial pigments containing only rutile or a mixture of rutile and anatase practically did not show any photocatalytic activity. The composition of the solutions after the degradation of lincomycin in the presence of TiO₂-P25 and ZnO differed significantly. Most of the identified organic degradation products contained conserved pharmacophores, and some of them could have been highly ecotoxic. Full article

Background: This paper reviews cost containment policies to control pharmaceutical expenditure either by regulating the pharmaceutical industry or targeting the demand side. Methods: The method used was the narrative literature review of studies which assessed the effect of pharmaceutical cost containment policies. Results: Governments worldwide have implemented a great variety of policy measures to manage pharmaceutical expenditure while ensuring fair access to essential medicines. Cost-sharing schemes, value-based pricing, reimbursement, reference pricing, payback mechanisms and the substitution of original drugs with generics and biosimilars are pivotal in these efforts, albeit with differing effectiveness across healthcare systems. Overall, it appears that any gains may be outweighed by the unfavorable effects of policies impacting patients. Although interventions have been created to improve physicians’ prescribing practice, they often achieve very minor benefits and at considerable cost. Policy measures pertaining to the regulation of the supply side must be supported by thorough evaluation in order to ascertain costs and effects and guarantee that unintended consequences are minimized. Conclusions: Policymakers frequently enact numerous laws and regulations to control pharmaceutical expenditure, even if there is limited evidence that they are cost-effective. The most crucial component of any policy’s success, regardless of the one selected, is its evaluation. Further research is needed to develop context-specific guidance that balances cost containment, equity and sustainability. Full article