Economic and quality of life burden of anemia on patients with CKD on dialysis: a systematic review

Abstract

Aims: The overall cost and health-related quality of life (HRQoL) associated with current treatments for chronic kidney disease (CKD)-related anemia are not well characterized. A systematic literature review (SLR) was conducted on the costs and HRQoL associated with current treatments for CKD-related anemia among dialysis-dependent (DD) patients.

Materials and methods: The authors searched the Cochrane Library, MEDLINE, EMBASE, NHS EED, and NHS HTA for English-language publications. Original studies published between January 1, 2000 and March 17, 2017 meeting the following criteria were included: adult population; study focus was CKD-related anemia; included results on patients receiving iron supplementation, red blood cell transfusion, or erythropoiesis stimulating agents (ESAs); reported results on HRQoL and/or costs. Studies which included patients with DD-CKD, did not directly compare different treatments, and had designs relevant to the objective were retained. HRQoL and cost outcomes, including healthcare resource utilization (HRU), were extracted and summarized in a narrative synthesis.

Results: A total of 1,625 publications were retrieved, 15 of which met all inclusion criteria. All identified studies included ESAs as a treatment of interest. Two randomized controlled trials reported that ESA treatment improves HRQoL relative to placebo. Across eight studies comparing HRQoL of patients achieving high vs low hemoglobin (Hb) targets, aiming for higher Hb targets with ESAs generally led to modest HRQoL improvements. Two studies reported that ESA-treated patients had lower costs and HRU compared to untreated patients. One study found that aiming for higher vs lower Hb targets led to reduced HRU, while two other reported that this led to a reduction in cost-effectiveness.

Limitations: Heterogeneity of study designs and outcomes; a meta-analysis could not be performed.

Conclusions: ESA-treated patients undergoing dialysis incurred lower costs, lower HRU, and had better HRQoL relative to ESA-untreated patients. However, treatment to higher Hb targets led to modest HRQoL improvements compared to lower Hb targets.     

Modeling shellfish harvest policies for food safety: Wild oyster harvest restrictions to prevent foodborne Vibrio vulnificus

Vibrio vulnificus has been identified as one of the main causative agents of foodborne disease associated with shellfish consumption. Infections of V. vulnificus increase during the summer months due to higher densities of the bacteria in warmer water and inappropriate handling of shellfish. In Florida, the daily harvest period is regulated to control the length of time between shellfish harvest and processing, and this harvest period has been recently reduced during the summer months to decrease the risk of foodborne disease. Adoption of this public health policy can affect the profitability and economic sustainability of wild oyster harvesters, especially in resource-dependent coastal communities. This study develops a dynamic and stochastic bioeconomic model to assess the impact of this policy on fishers’ harvest and revenues, and weighs that impact against the policy’s potential public health benefits. Our results show that fishers will experience reduced harvests early in the season due to the shorter harvest hours, but this initial loss is partially recouped later in the season as harvests remain high for longer than they would have if the policy were not in place. This study highlights the relationship between food safety interventions and management of fishery resources, and provides a comprehensive framework for evaluating the costs and benefits associated with such interventions.     

An empirical analysis: Did green supply chain management alleviate the effects of COVID-19?

Supply chain management played a central role during the COVID-19 crisis, as the outbreak of the pandemic disrupted the majority of all global supply chains. This paper tests whether companies that use green supply chain management (GSCM) practices benefited from a buffer effect in the context of COVID-19. Our empirical analysis, conducted on a sample of U.S. companies, shows that GSCM companies experienced less negative abnormal stock returns during the crisis. This result contributes to the literature on financial impact of GSCM, finding that GSCM is perceived as an effective risk management tool and can serve as an effective drug against COVID-19 crisis. Our paper also contributes to the business debate on the role of green supply chains in the post-COVID19 world.     

Nonparametric identification and estimation of current status data in the presence of death

We present a nonparametric study of current status data in the presence of death. Such data arise from biomedical investigations in which patients are examined for the onset of a certain disease, for example, tumor progression, but may die before the examination. A key difference between such studies on human subjects and the survival–sacrifice model in animal carcinogenicity experiments is that, due to ethical and perhaps technical reasons, deceased human subjects are not examined, so that the information on their disease status is lost. We show that, for current status data with death, only the overall and disease‐free survival functions can be identified, whereas the cumulative incidence of the disease is not identifiable. We describe a fast and stable algorithm to estimate the disease‐free survival function by maximizing a pseudo‐likelihood with plug‐in estimates for the overall survival rates. It is then proved that the global rate of convergence for the nonparametric maximum pseudo‐likelihood estimator is equal to O_p(n^?1/3) or the convergence rate of the estimated overall survival function, whichever is slower. Simulation studies show that the nonparametric maximum pseudo‐likelihood estimators are fairly accurate in small‐ to medium‐sized samples. Real data from breast cancer studies are analyzed as an illustration.     

The influence of the corporate social responsibility disclosures on consumer brand attitudes under the impact of COVID-19

This study focuses on the use of we-media by small- and medium-sized enterprises (SMEs) to disclose internal corporate social responsibility (ICSR) under the impact of the 2019 novel coronavirus disease (COVID-19). Study 1 interprets the catalyst effect of COVID-19 on the externalization of SMEs’ ICSR. The fuzzy grading evaluation method is initially verified. Under the impact of COVID-19, SMEs fulfilling their ICSR can enhance consumer brand attitudes. Study 2 uses a structural equation model and empirical analysis of 946 effective samples and finds that consumers perceive the self-sacrifice of corporations during the coronavirus disease period. SMEs can fulfill their ICSR to enhance the internal explanation mechanism of consumer brand attitudes and the moderating role of enterprise losses.     

Food deserts and diet-related health outcomes of the elderly

It is hypothesized that residents of neighborhoods with limited access to affordable and nutritious food face greater barriers to eating a healthy diet, which may in turn, result in worse health outcomes for them. Low-income elderly in urban areas may be uniquely affected by these so-called “food deserts” due to limited transportation options, strong attachments to local neighborhoods, fixed incomes, physical limitations in food shopping and meal preparation, and chronic health problems. Using the 2006, 2010, and 2014 waves of the Health and Retirement Study (HRS), the association between the food environment of elderly individuals living in urban Census tracts and their diet-related health was examined. Within urban areas, we find little evidence that food deserts negatively impact the health of lower income elderly individuals. Policies to address the needs of elderly residents of food deserts should be narrowly targeted and carefully justified.     

Stock markets’ reaction to COVID-19: Cases or fatalities?

In this paper, we examine the stock markets’ response to the COVID-19 pandemic. Using daily COVID-19 confirmed cases and deaths and stock market returns data from 64 countries over the period January 22, 2020 to April 17, 2020, we find that stock markets responded negatively to the growth in COVID-19 confirmed cases. That is, stock market returns declined as the number of confirmed cases increased. We further find that stock markets reacted more proactively to the growth in number of confirmed cases as compared to the growth in number of deaths. Our analysis also suggests negative market reaction was strong during early days of confirmed cases and then between 40 and 60 days after the initial confirmed cases. Overall, our results suggest that stock markets quickly respond to COVID-19 pandemic and this response varies over time depending on the stage of outbreak.     

Non‐parametric regression in clustered multistate current status data with informative cluster size

Datasets examining periodontal disease records current (disease) status information of tooth‐sites, whose stochastic behavior can be attributed to a multistate system with state occupation determined at a single inspection time. In addition, the tooth‐sites remain clustered within a subject, and the number of available tooth‐sites may be representative of the true periodontal disease status of that subject, leading to an ‘informative cluster size’ scenario. To provide insulation against incorrect model assumptions, we propose a non‐parametric regression framework to estimate state occupation probabilities at a given time and state exit/entry distributions, utilizing weighted monotonic regression and smoothing techniques. We demonstrate the superior performance of our proposed weighted estimators over the unweighted counterparts via a simulation study and illustrate the methodology using a dataset on periodontal disease.     

How different types of financial service providers support small- and medium enterprises under the impact of COVID-19 pandemic: From the perspective of expectancy theory

The 2019 novel coronavirus disease (COVID-19) pandemic has significantly impacted several aspects of the society and the economy. A problem that needs prompt attention in this situation is the increasing difficulties faced by small- and mediumsized enterprises (SMEs) in raising capital, which has aroused great concern from multiple stakeholders such as public administrations and regulators. As the major supply of capital, financial service providers (FSPs) play a critical role in financing SMEs. However, how FSPs deal with SME financing during shocks has not yet been fully researched. Accordingly, in this study, a theoretical framework based on expectancy theory is proposed to explore the expected strategic adjustments of FSPs in financing SMEs. Specifically, this study investigates 272 FSPs in China on their expectancy and attitude on financing to SMEs during the COVID-19 pandemic. Furthermore, this study has divided FSPs into three categories: commercial banks, non-bank financial institutions, and credit-enhanced FSPs. Differences among these categories are compared and analyzed.     

曲美他嗪治疗冠心病合并心力衰竭的临床疗效

目的：探讨曲美他嗪治疗冠心病合并心力衰竭患者的临床疗效。方法将40例冠心病合并心力衰竭患者随机分为两组，20例控制组患者给予常规治疗，20例试验组患者加用曲美他嗪治疗。比较两组患者的临床疗效。结果试验组患者临床治疗总有效率为95.0%，控制组患者总有效率为75.0%，试验组明显优于控制组，比较差异有统计学意义（P＜0.05）。结论曲美他嗪治疗冠心病合并心衰患者疗效确切。