Personalized Medicine: Boon or Budget-Buster?

2009 ◽  
Vol 43 (5) ◽  
pp. 958-962 ◽  
Author(s):  
Charles E Dean
Keyword(s):  
Drug Response ◽  
Genetic Factors ◽  
Current Approach ◽  
Molecular Medicine ◽  
Genetic Profile ◽  
Epigenetic Variation ◽  
Noncoding Regions ◽  
New Information ◽  
Current Economic Crisis ◽  
The Cost

While the development of personalized or molecular medicine is a laudable goal, there remain multiple barriers to its implementation. For example, little is known about the functions of noncoding regions of DNA, as well as the interplay of drug response, environmental factors, and the patient's genetic profile. In addition, there is a constant influx of new information on genetic factors such as epigenetic variation that could further complicate the development of medications based on the genetic profile, as well as the cost of profiling. However, assuming that clinically relevant genetic factors will be discovered and that drugs can be developed based on the molecular changes induced by those genetic factors, I suggest that the costs involved may substantially exceed the savings brought about by abandoning our current “one drug fits all” approach. While there is no doubt that our current approach is inefficient and expensive, remarkably little attention has been paid to the potential costs of molecular medicine. Given the current economic crisis, the time is ripe for a debate on this issue.

scholarly journals Drug Response Diversity: A Hidden Bacterium?

2021 ◽  
Vol 11 (5) ◽  
pp. 345
Author(s):  
Nadji Hannachi ◽  
Laurence Camoin-Jau
Keyword(s):  
Drug Response ◽  
Public Health Problem ◽  
Response To Treatment ◽  
Research Teams ◽  
Response Diversity ◽  
Drug Molecules ◽  
New Information ◽  
Genetic Level ◽  
Set Up ◽  
The Cost

Interindividual heterogeneity in response to treatment is a real public health problem. It is a factor that can be responsible not only for ineffectiveness or fatal toxicity but also for hospitalization due to iatrogenic effects, thus increasing the cost of patient care. Several research teams have been interested in what may be at the origin of these phenomena, particularly at the genetic level and the basal activity of organs dedicated to the inactivation and elimination of drug molecules. Today, a new branch is being set up, explaining the enigmatic part that could not be explained before. Pharmacomicrobiomics attempts to investigate the interactions between bacteria, especially those in the gut, and drug response. In this review, we provide a state of the art on what this field has brought as new information and discuss the challenges that lie ahead to see the real application in clinical practice.

Adopting IT

2011 ◽  
pp. 209-224
Author(s):  
John M. Anderson ◽  
William H. Gwinn
Keyword(s):  
Information Management ◽  
Information Technologies ◽  
Child Care Providers ◽  
Care Providers ◽  
Small Companies ◽  
Administrative Services ◽  
It Implementation ◽  
New Information ◽  
The World ◽  
The Cost

Small companies are often reluctant to try innovative approaches to information management because of the cost of the hardware and software, the potential disruption of processes already dependent on overstressed resources and the lack of in-house expertise. This case looks at the experience with information technology (IT) implementation of one small nonprofit company that provides administrative services for child care providers. Like many companies of all sizes, the focal company realized it must adopt new information technologies in order to survive. The company fit the profile for small companies just entering the world of IT. It experienced the expected internal problems associated with change. And then it discovered that its size and its relationship to government oversight agencies, themselves struggling to implement IT, posed special threats to its survival.

scholarly journals Major Role of Voluminosity in the Compressibility and Sol–Gel Transition of Casein Micelle Dispersions Concentrated at 7 °C and 20 °C

Foods ◽  
2019 ◽  
Vol 8 (12) ◽  
pp. 652
Author(s):  
Floriane Doudiès ◽  
Anne-Sophie Arsène ◽  
Fabienne Garnier-Lambrouin ◽  
Marie-Hélène Famelart ◽  
Antoine Bouchoux ◽  
...  
Keyword(s):  
Equilibrium Dialysis ◽  
Sol Gel ◽  
Casein Micelle ◽  
New Information ◽  
Wide Range ◽  
Sol Gel Transition ◽  
The Cost ◽  
Micelle Hydration ◽  
Gel Transition

The objective of this work is to bring new information about the influence of temperatures (7 °C and 20 °C) on the equation of state and sol–gel transition behavior of casein micelle dispersions. Casein micelle dispersions have been concentrated and equilibrated at different osmotic pressures using equilibrium dialysis at 7 °C and 20 °C. The osmotic stress technique measured the osmotic pressures of the dispersions over a wide range of concentrations. Rheological properties of concentrated dispersions were then characterized, respectively at 7 °C and at 20 °C. The essential result is that casein micelle dispersions are less compressible at 7 °C than at 20 °C and that concentration of sol–gel transition is lower at 7 °C than at 20 °C, with compressibility defined as the inverse to the resistance to the compression, and that is proportional to the cost to remove water from structure. From our interpretations, these two features were fully consistent with a release of soluble β-casein and nanoclusters CaP and an increased casein micelle hydration and apparent voluminosity at 7 °C as compared with 20 °C.

scholarly journals Technology Adoption under Uncertainty: Take-Up and Subsequent Investment in Zambia

2020 ◽  
Vol 102 (3) ◽  
pp. 617-632 ◽  
Author(s):  
Paulina Oliva ◽  
B. Kelsey Jack ◽  
Samuel Bell ◽  
Elizabeth Mettetal ◽  
Christopher Severen
Keyword(s):  
Cost Effectiveness ◽  
Technology Adoption ◽  
Tree Species ◽  
New Technology ◽  
New Information ◽  
Tree Survival ◽  
Two Stages ◽  
The Cost ◽  
On Farm ◽  
Multiple Stages

Technology adoption often requires multiple stages of investment. As new information emerges, agents may abandon a technology that was profitable in expectation. We use a field experiment to vary the payoffs at two stages of investment in a new technology: a tree species that provides on-farm fertilizer benefits. Farmer decisions identify the information about profitability that arrives between the take-up and follow-through stages. Results show that this form of uncertainty increases take-up but lowers average tree survival, decreasing the cost-effectiveness of take-up subsidies. Thus, uncertainty offers another explanation for why even costly technologies may go unused or be abandoned.

Pharmacogenetics in oncology: Where we stand today?

2016 ◽  
Vol 1 (1) ◽  
pp. 2 ◽  
Author(s):  
Padmaj S. Kulkarni
Keyword(s):  
Drug Targets ◽  
Drug Response ◽  
Chemotherapeutic Drugs ◽  
Nucleotide Polymorphisms ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Metabolizing Enzymes ◽  
Single Nucleotide ◽  
A Genome ◽  
The Right ◽  
The Cost

<p>In a given population, there is considerable variation between individuals with regard to response to as well as toxicity of different drugs. The term “Pharmacogenetics” has largely been used in relation to genes determining drug metabolism, while “Pharmacogenomics” is a broader based term that encompasses all genes in a genome that may determine drug response. In oncology, efficacy and safety of many chemotherapeutic drugs show substantial individual and/or population variability. It can be explained, to a great extent, by gene polymorphism encoding drug-metabolizing enzymes, drug transporters, and drug targets which influence the pharmacokinetics and pharmacodynamics and affect clinical outcomes. Single nucleotide polymorphisms (SNPs) are the most studied genetic variants at present due to ease, accuracy, and reduced the cost of processing as well as due to public availability of online resources for SNPs. Candidate genes for a therapeutic and adverse response can be divided into three categories: Pharmacokinetic, receptor/target, and disease-modifying. Many anticancer drugs are evaluated for their variation in response according to germline variations. This information can be easily incorporated in day-to-day practice to improve efficacy and/or safety of these drugs. In the future, advances gained from pharmacogenetics research will provide information to guide doctors in advising just enough of the right medicine to a person – The practice of “personalized medicine.”</p>

Building a Rapid Learning Health Care System for Oncology: The Regulatory Framework of CancerLinQ

2014 ◽  
Vol 32 (22) ◽  
pp. 2373-2379 ◽  
Author(s):  
Richard L. Schilsky ◽  
Dina L. Michels ◽  
Amy H. Kearbey ◽  
Peter Paul Yu ◽  
Clifford A. Hudis
Keyword(s):  
Health Care ◽  
Big Data ◽  
Quality Care ◽  
Quality Measurement ◽  
New Drugs ◽  
Large Numbers ◽  
New Information ◽  
American Society ◽  
Clinical Records ◽  
The Cost

Today is a time of unprecedented opportunity and challenge in health care generally and cancer care in particular. An explosion of scientific knowledge, the rapid introduction of new drugs and technologies, and the unprecedented escalation in the cost of health care challenge physicians to quickly assimilate new information and appropriately deploy new advances while also delivering efficient and high-quality care to a rapidly growing and aging patient population. At the same time, big data, with its potential to drive rapid understanding and innovation, promises to transform the health care industry, as it has many others already. CancerLinQ is an initiative of the American Society of Clinical Oncology (ASCO) and its Institute for Quality, developed to build on these opportunities and address these challenges by collecting information from the electronic health records of large numbers of patients with cancer. CancerLinQ is, first and foremost, a quality measurement and reporting system through which oncologists can harness the depth and power of their patients' clinical records and other data to improve the care they deliver. The development and deployment of CancerLinQ raises many important questions about the use of big data in health care. This article focuses on the US federal regulatory pathway by which CancerLinQ will accept patient records and the approach of ASCO toward stewardship of the information.

The Design of Injection Mold Assembly System Based on the Virtual Reality Technology

2012 ◽  
Vol 522 ◽  
pp. 757-760
Author(s):  
Jian Zhang ◽  
Wen Lei Sun ◽  
Xiang Long Wang ◽  
Chun Xiang Wang ◽  
Shu Jun Guo
Keyword(s):  
Virtual Reality ◽  
Information Exchange ◽  
External Control ◽  
Assembly System ◽  
Injection Mold ◽  
Virtual Reality Technology ◽  
Display Devices ◽  
New Information ◽  
Assembly Technology ◽  
The Cost

Traditional injection mould development needs longer cycle and higher cost, while the use of virtual assembly technology can greatly reduce the cost of the design process. Besides, the cost of newly designed products injection mold shaping and its die trial was very expensive; yet virtual mold assembly system can reduce the cost in the process of actual assembly. The simulation system of injection mold assembly and modeling can be designed by applying the virtual reality technology and its virtual roaming displaying can be achieved with external control and display devices on the virtual interaction platform of the Nvision. Finally utilizing man-machine interface technology can make users immersed in a virtual environment, realize man-machine interaction and provide a brand-new information exchange interface superior to the traditional manifestation way.

scholarly journals Governança Corporativa e Velocidade de Incorporação de Informações: Lead-Lag entre o IGC e o IBrX

2012 ◽  
Vol 10 (1) ◽  
pp. 149
Author(s):  
José Carneiro da Cunha Oliveira Neto ◽  
Otávio Ribeiro de Medeiros ◽  
Thiago Bergmann de Queiroz
Keyword(s):  
Corporate Governance ◽  
Causality Test ◽  
Market Prices ◽  
Vector Error Correction ◽  
Vector Error ◽  
New Information ◽  
Equilibrium Relationship ◽  
Intraday Data ◽  
Two Stages ◽  
The Cost

Based on intraday data with a frequency of 15 minutes, the present study investigates the relationship between the high corporate governance market (IGC) and the traditional market (IBrX). The hypothesis tested is that a higher level of corporate governance reduces the cost associated to incorporating new information to asset prices, and so firms with higher governance incorporate information faster. The co-integration relationship between the time series was tested using the Engle-Granger method in two stages. The vector error correction model (VECM) and the Granger causality test do not permit the rejection of the hypothesis of faster incorporation of information for the high governance market prices. To estimate the VECM we used a bivariate GARCH BEKK model. The results suggest that the IGC finds its equilibrium price more rapidly and that the IBrX converges to the equilibrium relationship determined by the IGC.

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