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Determining fair medicines prices. What do citizens think?
No full textObjectives: There is a lively debate about the fair price of medicines, mainly led by experts. Little is known about the public's opinion, although in most health systems with universal coverage medicines are procured by public money through payers or governments. This study assesses public opinion about fair medicine prices, the criteria that define fairness, and the policy implications. Methods: A population survey amongst 1000 people across the Swiss population in all 3 language regions has been conducted between September and October 2024. Results: Access for all (986), transparency of the cost structure (914) and a price reflecting the costs of a medicine (911) have ranked as the most relevant factors for a fair price of medicine. In contrast, the additional benefit of a new therapy is considered less important as a criterion. A large majority supports pharmaceutical companies making a profit. Asked how to align the different objectives, the majority supports the statement that medicines prices should be the result of a fair process (568), followed by the statement that governments should control profits (431). Conclusions: This study suggests that citizens consider the balance between patient access and investment in research and development as the most relevant for a fair price of a medicine. When access and cost create a dilemma, citizens favour fair procedures. In contrast to expert opinions, the additional benefit of a medicine seems to be a less relevant criterion. The survey results indicate a nuanced and pragmatic approach to fairness, considering societal, scientific, and economic factors
Nuances in the memory undermining effects of EMDR and imagery rescripting
No full textWe reviewed the evidence on the memory undermining ef(EMDR) and imagery rescripting. Both therapies appear to undermine memory quality by making memories less vivid and emotionally-negative. Also, while eye movements used in EMDR seem to increase spontaneous false memories, they do not increase the susceptibility to suggestion. Inconsistent findings have emerged on the effects of imagery rescripting on false memory generation. Furthermore, a substantial number of clinicians who use EMDR strongly believe in the notion of repressed memory and EMDR has been associated with the occurrence of recovered memories. The belief in repressed memory might encourage suggestive therapeutic techniques, thereby increasing the risk of false memory creation. Overall, nuance is required on potential memory undermining effects of EMDR and imagery rescripting
Unbalanced Data Supported by Federated Learning with Uncertainty by Different Aggregation Methods
No full textFederated learning enables multiple clients to collaboratively train a machine learning model while keeping their local data private-omitting sharing data, making it a privacy-preserving technique. Data plays a key role in these models. However, in some cases, a single organization may not have enough data or high-quality data to build a reliable model, especially in a rapidly changing environment. In horizontal federated learning, each organization/client continuously refines its model, which is periodically fused and distributed among all participating clients in the federation for further enhancement. The fusion/aggregation process typically relies on a weighted averaging approach, where the weights are determined by the quality of each client’s model. This study explores approaches by using federated learning with respect to uncertainty and examines various aggregation strategies based on the performance of local models
Cross-border victims in the Netherlands
No full textThis chapter presents the situation of cross-border victims in the Netherlands, a country that is a major tourist destination, as well as an important travel, migration, and economic hub (with Schiphol Airport and the Rotterdam Harbour). The Netherlands also serves as a destination for large numbers of labour and refugee immigrants. The author observes that while the legal framework of victims’ rights is well established, the legal and policy framework relevant to cross-border victims in the Netherlands remains a developing field. The chapter includes a summary of the current state of victim rights in the Netherlands, with particular attention paid to the rights available to cross-border victims (foreign residents who were victimized in the Netherlands and Dutch residents victimized abroad). It also discusses victim support services and the access cross-border victims have to these services in practice, drawing heavily on the author's interviews with four practitioners and policymakers working in the field of criminal justice or victim support. The chapter ends with examples of good practices in the field of confiscation and residence rights, as well as some closing remarks on the desired development of victim support and protection
Adaptive Retraining Techniques for Foreign Object Detection in Industrial Environments
No full textForeign-object detection systems based on machine learning perform well when trained on a substantial amount of high-quality data that reflect well the environment in which they will be deployed. In industrial applications, data are often not readily available, and the collection and annotation of data is accompanied by large costs, labour, and time. Moreover, over time, the industrial setting may change, and the previously fine-tuned machine-learning model may not be suitable to the changed setting anymore. We propose a novel active-learning based method for foreign object detection that addresses these problems. Our method strategically selects the samples for automatic labelling or manual annotation on the basis of class-specific accuracy. Moreover, a class-based sampling technique is employed to maintain the class balance to avoid catastrophic forgetting. Experimental results demonstrate that our method achieves comparable accuracy to the model trained with all data with fewer samples, thus reducing cost for labelling, saving time, and lowering computational complexity to retrain
Can the Assessment of Burden of Chronic Conditions (ABCC) Tool contribute to person-centered care?
No full textChronic conditions represent an increasing public health challenge. While concepts like person-centered care, shared decision-making, and self-management are increasingly promoted, their practical realization remains difficult within our disease-centered healthcare system. The Assessment of Burden of Chronic Conditions (ABCC) tool may contribute to a more person-centered approach within the current healthcare system. This tool can support patients and healthcare providers in developing personalized care plans by measuring and visualizing perceived disease burden. Research indicates that the questions within the ABCC tool are valid and reliable for COPD, asthma, type 2 diabetes, chronic heart failure, osteoarthritis, and colorectal cancer. An effectiveness study found that using the tool resulted in significant differences in perceived quality of care and patient activation compared to control. However, outcomes like quality of life and well-being showed no significant differences in this study. Future research should focus on validation for multimorbidity, long-term effects, and implementation strategies
Coconvex characters on collections of phylogenetic trees
No full textIn phylogenetics, a key problem is to construct evolutionary trees from collections of characters where, for a set X of species, a character is simply a function from X onto a set of states. In this context, a key concept is convexity, where a character is convex on a tree with leaf set X if the collection of subtrees spanned by the leaves of the tree that have the same state are pairwise disjoint. Although collections of convex characters on a single tree have been extensively studied over the past few decades, very little is known about coconvex characters, that is, characters that are simultaneously convex on a collection of trees. As a starting point to better understand coconvexity, in this paper we prove a number of extremal results for the following question: What is the minimal number of coconvex characters on a collection of n-leaved trees taken over all collections of size t=2, also if we restrict to coconvex characters which map to k states? As an application of coconvexity, we introduce a new one-parameter family of tree metrics, which range between the coarse Robinson-Foulds distance and the much finer quartet distance. We show that bounds on the quantities in the above question translate into bounds for the diameter of the tree space for the new distances. Our results open up several new interesting directions and questions which have potential applications to, for example, tree spaces and phylogenomics
Lung metastases
No full textUp to 50% of patients with metastatic cancer develop lung metastases during their disease course. Lung metastases are linked to poor prognosis across various cancer types and might impair the quality of life of patients, causing dyspnoea, cough, haemoptysis and pain, potentially diminishing physical, functional and emotional well-being. Lung metastases arise from a complex interplay of tumour-secreted factors such as VEGF, TGFβ and CCL2, which drive vascular remodelling, immune cell recruitment and extracellular matrix reprogramming. Additionally, tumour-derived exosomes and microparticles contribute to organotropism and immunosuppression by altering the lung microenvironment. The ensemble of these modifications creates a pre-metastatic niche conducive to tumour cell colonization and outgrowth. Lung metastases are primarily diagnosed through imaging; histological confirmation is sometimes required to distinguish them from primary lung cancer. The size and number of lung metastases, timing of primary cancer treatment, histology, and the patient’s clinical condition are all considered to determine the most appropriate treatment. When a locoregional approach is not possible, histology-based, molecular-driven systemic therapy is the choice. No systemic treatment is currently available specifically for lung metastases. Advances in understanding the distinct stages of pre-metastatic niche formation and lung metastasis outgrowth might lead to the development of prevention strategies and tailored treatments.</p
ToF-SIMS spectra of caffeic acid, vanillin, eugenol, and cellulose in positive polarity
No full textInitially used for fermentation or storage, oak wood barrels were found to enhance the organoleptic properties of spirits. Over time, wood compounds have been linked to the quality of the spirits. ToF-SIMS being an ionization technique that produces intense fragmentation patterns which are not fully understood, reference spectra are required to confidently analyze wood samples. Here, positive polarity ToF-SIMS reference spectra of important oak wood compounds being involved in spirit maturation, using a Bi3+ primary ion species, are presented