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https://www.readbyqxmd.com/read/28944729/using-performance-based-risk-sharing-arrangements-to-address-uncertainty-in-indication-based-pricing
#1
Kai Yeung, Meng Li, Josh J Carlson
BACKGROUND: The rise in pharmaceutical expenditures in recent years has increased health care payer interest in ensuring good value for the money. Indication-based pricing (IBP) sets separate, indication-specific prices paid to the manufacturer according to the expected efficacy of a drug in each of its indications. IBP allows payers to consistently pay for value across indications. While promising, a limitation of IBP as originally conceived is that efficacy estimates are typically based on clinical trial data, which may differ from real-world effectiveness...
October 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28944726/paying-for-cures-how-can-we-afford-it-managed-care-pharmacy-stakeholder-perceptions-of-policy-options-to-address-affordability-of-prescription-drugs
#2
Kai Yeung, Kangho Suh, Anirban Basu, Louis P Garrison, Aasthaa Bansal, Josh J Carlson
BACKGROUND: High-priced medications with curative potential, such as the newer hepatitis C therapies, have contributed to the recent growth in pharmaceutical expenditure. Despite the obvious benefits, health care decision makers are just beginning to grapple with questions of how to value and pay for curative therapies that may feature large upfront cost, followed by health benefits that are reaped over a patient's lifespan. Alternative policy options have been proposed to promote high value and financially sustainable use of these therapies...
October 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28944717/an-overview-of-assessment-methodology-for-obesity-related-variables-in-infants-at-risk
#3
Danae Dinkel, Corrine Hanson, Karsten Koehler, Ann Anderson Berry, Anastasia Kyvelidou, Matthew Bice, Jill Wallen, Danstan Bagenda, Laura Jana, Jana Pressler
BACKGROUND: The first 2 years of a child's life are a particularly critical time period for obesity prevention. AIM: An increasing amount of research across the world is aimed at understanding factors that impact early childhood obesity and developing interventions that target these factors effectively. With this growing interest, new and interdisciplinary research teams are developing to meet this research need. Due to rapid growth velocity during this phase of the lifespan, typical assessments used in older populations may not be valid or applicable in infants, and investigators need to be aware of the pros and cons of specific methodological strategies...
January 1, 2017: Nutrition and Health
https://www.readbyqxmd.com/read/28944646/acute-blood-glucose-cardiovascular-and-exaggerated-responses-to-high-intensity-interval-training-and-moderate-intensity-continuous-training-in-men-with-type-2-diabetes-mellitus
#4
Shohn G Wormgoor, Lance C Dalleck, Caryn Zinn, Nigel K Harris
BACKGROUND: Optimising exercise-induced physiological responses without increasing the risk of negative exaggerated responses is an important aspect of exercise prescription for people with type 2 diabetes mellitus (T2DM). However, knowledge of acute responses, including exaggerated responses, of different training modalities is limited. AIM: To compare acute physiological responses of moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT) in T2DM...
September 22, 2017: Journal of Sports Medicine and Physical Fitness
https://www.readbyqxmd.com/read/28944304/wearable-technology-to-reduce-sedentary-behavior-and-cvd-risk-in-older-adults-design-of-a-randomized-controlled-trial
#5
Lisa M Krehbiel, Andrew S Layne, Bhanuprasad Sandesara, Todd M Manini, Stephen D Anton, Thomas W Buford
Persons aged over 65 years account for over the vast majority of healthcare expenditures and deaths attributable to cardiovascular disease (CVD). Accordingly, reducing CVD risk among older adults is an important public health priority. Structured physical activity (i.e. exercise) is a well-documented method of decreasing CVD risk, but recent large-scale trials suggest that exercise alone is insufficient to reduce CVD events in high-risk populations of older adults. Thus adjuvant strategies appear necessary to reduce CVD risk...
June 2017: Contemporary Clinical Trials Communications
https://www.readbyqxmd.com/read/28944271/the-effect-of-passive-heating-on-heat-shock-protein-70-and-interleukin-6-a-possible-treatment-tool-for-metabolic-diseases
#6
S H Faulkner, S Jackson, G Fatania, C A Leicht
Increasing physical activity remains the most widely publicized way of improving health and wellbeing. However, in populations that benefit most from exercise (EX), adherence is often poor and alternatives to EX are important to bring about health improvements. Recent work suggests a role for passive heating (PH) and heat shock proteins (HSP) in improving cardio-metabolic health. The aim of this study was to investigate the expression of HSP70 and interleukin-6 in response to either EX or PH and the subsequent effect on glucose control...
2017: Temperature: Multidisciplinary Biomedical Journal
https://www.readbyqxmd.com/read/28944087/exercise-induced-irisin-in-bone-and-systemic-irisin-administration-reveal-new-regulatory-mechanisms-of-bone-metabolism
#7
Jin Zhang, Paloma Valverde, Xiaofang Zhu, Dana Murray, Yuwei Wu, Liming Yu, Hua Jiang, Michel M Dard, Jin Huang, Zhiwei Xu, Qisheng Tu, Jake Chen
Irisin is a polypeptide hormone derived from the proteolytic cleavage of fibronectin-type III domain-containing 5 (FNDC5) protein. Once released to circulation upon exercise or cold exposure, irisin stimulates browning of white adipose tissue (WAT) and uncoupling protein 1 (UCP1) expression, leading to an increase in total body energy expenditure by augmented UCP1-mediated thermogenesis. It is currently unknown whether irisin is secreted by bone upon exercise or whether it regulates bone metabolism in vivo...
2017: Bone Research
https://www.readbyqxmd.com/read/28943448/molecular-integration-of-incretin-and-glucocorticoid-action-reverses-immunometabolic-dysfunction-and-obesity
#8
Carmelo Quarta, Christoffer Clemmensen, Zhimeng Zhu, Bin Yang, Sini S Joseph, Dominik Lutter, Chun-Xia Yi, Elisabeth Graf, Cristina García-Cáceres, Beata Legutko, Katrin Fischer, Robert Brommage, Philippe Zizzari, Bernardo S Franklin, Martin Krueger, Marco Koch, Sabine Vettorazzi, Pengyun Li, Susanna M Hofmann, Mostafa Bakhti, Aimée Bastidas-Ponce, Heiko Lickert, Tim M Strom, Valerie Gailus-Durner, Ingo Bechmann, Diego Perez-Tilve, Jan Tuckermann, Martin Hrabě de Angelis, Darleen Sandoval, Daniela Cota, Eicke Latz, Randy J Seeley, Timo D Müller, Richard D DiMarchi, Brian Finan, Matthias H Tschöp
Chronic inflammation has been proposed to contribute to the pathogenesis of diet-induced obesity. However, scarce therapeutic options are available to treat obesity and the associated immunometabolic complications. Glucocorticoids are routinely employed for the management of inflammatory diseases, but their pleiotropic nature leads to detrimental metabolic side effects. We developed a glucagon-like peptide-1 (GLP-1)-dexamethasone co-agonist in which GLP-1 selectively delivers dexamethasone to GLP-1 receptor-expressing cells...
September 19, 2017: Cell Metabolism
https://www.readbyqxmd.com/read/28943398/cold-sensing-trpm8-channel-participates-in-circadian-control-of-the-brown-adipose-tissue
#9
Maria Nathália Moraes, Leonardo Vinicius Monteiro de Assis, Felipe Dos Santos Henriques, Miguel Luiz Batista Junior, Ali D Güler, Ana Maria de Lauro Castrucci
Transient receptor potential (TRP) channels are known to regulate energy metabolism, and TRPM8 has become an interesting player in this context. Here we demonstrate the role of the cold sensor TRPM8 in the regulation of clock gene and clock controlled genes in brown adipose tissue (BAT). We investigated TrpM8 temporal profile in the eyes, suprachiasmatic nucleus and BAT; only BAT showed temporal variation of TrpM8 transcripts. Eyes from mice lacking TRPM8 lost the temporal profile of Per1 in LD cycle. This alteration in the ocular circadian physiology may explain the delay in the onset of locomotor activity in response to light pulse, as compared to wild type animals (WT)...
September 21, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28941598/energy-matched-moderate-and-high-intensity-exercise-training-improves-nonalcoholic-fatty-liver-disease-risk-independent-of-changes-in-body-mass-or-abdominal-adiposity-a-randomized-trial
#10
Nathan C Winn, Liu Ying, R Scott Rector, Elizabeth J Parks, Jamal A Ibdah, Jill A Kanaley
BACKGROUND AND PURPOSE: Exercise training is commonly prescribed for individuals diagnosed with nonalcoholic fatty liver disease (NAFLD); however, consensus regarding the volume and intensity of exercise for optimal benefits is lacking. Thus, we determined whether high intensity interval exercise training (HIIT) produced greater reductions in intrahepatic lipid (IHL) content and NAFLD risk factors compared with energy-matched moderate intensity continuous exercise training (MICT) in obese adults with liver steatosis...
September 20, 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28940913/spatial-effects-in-hospital-expenditures-a-district-level-analysis
#11
Matteo Lippi Bruni, Irene Mammi
We use spatial econometric methods to analyse spillovers in hospital expenditures across Health Districts of the Emilia-Romagna Region (Italy). We estimate spatial models that allow for global spillovers and distinguish between the expenditures associated with potentially inappropriate hospitalizations and those associated with complex medical procedures. We also investigate the relative contribution of geographical and institutional proximity in explaining spatial dependence, by explicitly modelling different connectivity structures and exploiting them to build alternative spatial weight matrices...
September 2017: Health Economics
https://www.readbyqxmd.com/read/28940741/hypermetabolism-appears-to-be-an-adverse-prognostic-biomarker-in-als-a-potential-for-therapeutic-intervention
#12
Steve Vucic
Hypermetabolism has been identified as a potential pathophysiological process in approximately 50-60% of amyotrophic lateral sclerosis (ALS) patients and is characterised by an increase in the resting energy expenditure (REE), a measure of total daily energy expenditure [1, 2]. The finding of hypermetabolism in ALS is unexpected given that ALS patients exhibit lower weight and free fat mass (FFM), both of which would lead to hyopmetabolism [3]. This article is protected by copyright. All rights reserved.
September 20, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28940704/hypermetabolism-is-a-deleterious-prognostic-factor-in-patients-with-amyotrophic-lateral-sclerosis
#13
Pierre Jésus, Philippe Fayemendy, Marie Nicol, Géraldine Lautrette, Huguette Sourisseau, Pierre-Marie Preux, Jean-Claude Desport, Benoit Marin, Philippe Couratier
The aim of this study was to investigate in ALS patients in order to determine their nutritional, neurological and respiratory parameters and their survival according to the metabolic level. METHODS: Nutritional assessment included resting energy expenditure (REE) measured by indirect calorimetry (hypermetabolism if REE variation [ΔREE] > 10%) and fat mass (FM) using impedancemetry. Neurological assessment included ALSFRS-R score. Survival analysis used the Kaplan-Meier method and the multivariate Cox model...
September 20, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28940659/physical-activity-and-22-year-all-cause-and-coronary-heart-disease-mortality
#14
Niklas Krause, Onyebuchi A Arah, Jussi Kauhanen
BACKGROUND: This study explores the effects of occupational (OPA) and leisure time physical activity (LTPA) on mortality relative to cardiorespiratory fitness and pre-existing coronary heart disease (CHD). METHODS: Associations between OPA, measured as energy expenditure (kcal/day) and relative aerobic workload (%VO2 max), LTPA, and 22-year mortality among 1891 Finnish men were assessed by Cox regression models stratified by CHD and adjusted for 19 confounders. RESULTS: In fully adjusted models, each 10% of relative aerobic workload increased all-cause mortality by 13% and CHD mortality 28% (P < 0...
September 20, 2017: American Journal of Industrial Medicine
https://www.readbyqxmd.com/read/28939229/photon-and-proton-radiation-therapy-utilization-in-a-population-of-more-than-100-million-commercially-insured-patients
#15
Mark R Waddle, Terence T Sio, Holly K Van Houten, Robert L Foote, Sameer R Keole, Steven E Schild, Nadia Laack, Thomas B Daniels, William Crown, Nilay D Shah, Robert C Miller
PURPOSE: To characterize the changes in the use of radiation therapy (RT), specifically proton beam radiation therapy (PBRT), among adult and pediatric patients over a 11-year period in a very large population of insured patients. METHODS AND MATERIALS: We conducted a retrospective analysis of the OptumLabs Data Warehouse claims database of more than 100 million insured US enrollees. Descriptive analyses were undertaken to evaluate the characteristics of patients receiving RT from 2002 to 2012...
August 2, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28939058/regions-of-mrap2-required-for-the-inhibition-of-orexin-and-prokineticin-receptor-signaling
#16
Alix A J Rouault, Abigail A Lee, Julien A Sebag
The Melanocortin Receptor Accessory Protein 2 (MRAP2) regulates the activity of several GPCRs involved in the control of food intake and energy expenditure. While MRAP2 was originally thought to exclusively interact with melanocortin receptors we have recently shown that it interacts with and inhibits the trafficking and signaling of the prokineticin receptor 1 (PKR1). In this study we demonstrate a new role of MRAP2 in the regulation of the orexin receptor 1 (OX1R) and identify the specific regions of MRAP2 required for the regulation of OX1R and PKR1...
September 19, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28938473/the-role-of-episodic-postprandial-peptides-in-exercise-induced-compensatory-eating
#17
Catherine Gibbons, John E Blundell, Phillipa Caudwell, Dominic-Luc Webb, Per M Hellström, Erik Näslund, Graham Finlayson
Purpose: Prolonged physical activity gives rise to variable degrees of body weight and fat loss, and is associated with variability in appetite control (hunger and energy intake). Whether these effects are modulated by postprandial 'episodic' peptides is unclear. We examined the role of postprandial peptide response in compensatory eating during 12-weeks aerobic exercise and in response to high (HFLC) and low fat (LFHC) meals. Methods: 32 overweight/obese individuals - 16 completed 12-weeks aerobic exercise and 16 were age- and BMI-matched non-exercising controls...
August 18, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28938472/dopamine-neuron-restricted-leptin-receptor-lepr-signaling-reduces-some-aspects-of-food-reward-but-exacerbates-the-obesity-of-lepr-deficient-male-mice
#18
Maggie C Evans, Greg M Anderson
The contribution of leptin-induced modulation of dopamine neurons to feeding behavior and energy homeostasis remains unclear. Midbrain dopamine neurons regulate the reward value of food, and direct leptin administration to the midbrain reduces food intake. However, selective deletion of leptin receptors (Lepr) from dopamine neurons has no effect on body weight, food intake or hedonic responses, either suggesting leptin acts indirectly or demonstrating sufficient compensation occurs to mask any direct leptin-dopamine effects...
August 18, 2017: Endocrinology
https://www.readbyqxmd.com/read/28938414/sex-and-tissue-specific-role-of-estrogen-sulfotransferase-in-energy-homeostasis-and-insulin-sensitivity
#19
Wojciech G Garbacz, Mengxi Jiang, Meishu Xu, Jun Yamauchi, H Henry Dong, Wen Xie
Estrogen Sulfotransferase (EST) catalyzes the sulfoconjugation and deactivation of estrogens. Previously we showed that loss of Est in male ob/ob mice, but not in female ob/ob mice, exacerbated the diabetic phenotype, but the underlying mechanism was unclear. Here we show that transgenic reconstitution of Est in the adipose tissue, but not in the liver, attenuated diabetic phenotype in Est deficient ob/ob mice (obe). Mechanistically, adipose reconstitution of Est in obe mice (oae) resulted in reduced local and systemic inflammation, improved insulin sensitivity, and increased energy expenditure...
September 5, 2017: Endocrinology
https://www.readbyqxmd.com/read/28938248/a-youth-compendium-of-physical-activities-activity-codes-and-metabolic-intensities
#20
Nancy F Butte, Kathleen B Watson, Kate Ridley, Issa F Zakeri, Robert G McMurray, Karin A Pfeiffer, Scott E Crouter, Stephen D Herrmann, David R Bassett, Alexander Long, Zekarias Berhane, Stewart G Trost, Barbara E Ainsworth, David Berrigan, Janet E Fulton
PURPOSE: A Youth Compendium of Physical Activities (Youth Compendium) was developed to estimate the energy costs of physical activities using data on youth only. METHODS: Based on a literature search and pooled data of energy expenditure measurements in youth, the energy costs of 196 activities were compiled in 16 activity categories to form a Youth Compendium of Physical Activities. To estimate the intensity of each activity, measured oxygen consumption (V[Combining Dot Above]O2) was divided by basal metabolic rate (Schofield age-, sex- and mass-specific equations) to produce a youth MET (METy)...
September 21, 2017: Medicine and Science in Sports and Exercise
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