Search

Background: The N2-fixing cyanobacterium, Aphanizomenon flos-aquae is a globally distributed bloom causing species that degrades water quality of fresh and marine water bodies. Overcoming phosphorus (P) deficiency is one of the ecological advantages for bloom-forming cyanobacteria. It remains unclear to what extent can A. flos-aquae alleviate P deficiency by regulating P using strategies. Results: Based on in situ observations of extracellular alkaline phosphatase (APase) in A. flos-aquae via enzyme-labeled fluorescence in freshwater bodies in China, Poland and Czechia, we further investigated responses of isolated A. flos-aquae to different P supplies (dissolved inorganic P (Pi) as +DIP, dissolved organic α-glycerophosphate and β-glycerophosphate as +DOPα and +DOPβ, P-free condition as P-depleted). The significantly negative relationships between percentage of APase producing cells and soluble reactive P concentration in both fields and cultures suggested that the excretion of APase in cyanobacterium was regulated by ambient Pi supply. Suffering from P deficiency in the P-depleted treatments, A. flos-aquae showed the highest APase activity but a vigorous growth at the early culture stage, which might also benefit from the formation of polyphosphate body (PPB) and the decrease of cell P quota. In the +DOP treatments, the coordination of dissolved DOP mineralization and continuous prompt utilization of PPB might contribute to a maintenance but not reproduction of A. flos-aquae when relying on DOP, since the specific growth rate kept around 0 cells L−1 day−1 at the second half culture period and the highest cell density reached only 13.38% of that in +DIP treatments while photochemical efficiency was comparable during the whole experiment. Luxury uptake of phosphate as PPB in the +DIP treatments was consistent to the canonical view of polyphosphate as P storage. Conclusion: Aphanizomenon flos-aquae could achieve an instantaneous growth in response to P deficiency with the coordination of P utilization strategies, while it maintained a long-term sustainable growth but not reproduction under sole DOP supply. Persistent and active reproduction could only be achieved in high Pi supply, which implying that an effective consequence can be expected for combating the bloom of A. flos-aquae when controlling P supply. [ABSTRACT FROM AUTHOR]

Background: As economic considerations become more important in healthcare reimbursement, decisions about the further development of medical innovations need to take into account not only medical need and potential clinical effectiveness, but also cost-effectiveness. Already early in the innovation process economic evaluations can support decisions on development in specific indications or patient groups by anticipating future reimbursement and implementation decisions. One potential concept for early assessment is value-based pricing.Methods: The objective is to assess the feasibility of value-based pricing and product design for a hypothetical vascular closure device in the pre-clinical stage which aims at decreasing bleeding events. A deterministic decision-analytic model was developed to estimate the cost-effectiveness of established vascular closure devices from the perspective of the Statutory Health Insurance system. To identify early benchmarks for pricing and product design, three strategies of determining the product's value are explored: 1) savings from complications avoided by the new device; 2) valuation of the avoided complications based on an assumed willingness-to-pay-threshold (the efficiency frontier approach); 3) value associated with modifying the care pathways within which the device would be applied.Results: Use of established vascular closure devices is dominated by manual compression. The hypothetical vascular closure device reduces overall complication rates at higher costs than manual compression. Maximum cost savings of only about €4 per catheterization could be realized by applying the hypothetical device. Extrapolation of an efficiency frontier is only possible for one subgroup where vascular closure devices are not a dominated strategy. Modifying care in terms of same-day discharge of patients treated with vascular closure devices could result in cost savings of €400-600 per catheterization.Conclusions: It was partially feasible to calculate value-based prices for the novel closure device which can be used to inform product design. However, modifying the care pathway may generate much more value from the payers' perspective than modifying the device per se. Manufacturers should thus explore the feasibility of combining reimbursement of their product with arrangements that make same-day discharge attractive also for hospitals. Due to the early nature of the product, the results are afflicted with substantial uncertainty. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Agriculture & Forestry is the property of Scientific and Technical Research Council of Turkey and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)