Fresenius Kabi (Czechia)

<h3>Background and Importance</h3> A survey of market access experts of the Medical Nutrition International Industry was undertaken to understand the barriers contributing to inequity in optimal nutritional care in Europe. <h3>Aim and Objectives</h3> Disease-related malnutrition (DRM), an underdiagnosed, undertreated public health problem that affects 30–50% of hospital inpatients, results in poor health outcomes and higher costs.¹ Multidisciplinary care, including pharmacists, is essential to ensure optimal nutritional interventions.² Pharmacists are vital to multidisciplinary care coordination. Medical nutrition therapy is cost-effective and improves health outcomes, yet inequity exists in access.¹ This survey was conducted to address the limited insight across countries into the major barriers to implementation of equitable nutritional care beyond health technology assessment. <h3>Material and Methods</h3> An online survey was developed by the MNI, and members (n=6) participated between April and December 2024. Additional responses were included (National Industry Groups n=2; additional MNI members n=2). Results covered Croatia, France, Germany, Italy, Poland, Portugal, Spain, Switzerland, The Netherlands and the United Kingdom. Quantitative data were reported as percentages and qualitative data as key themes. <h3>Results</h3> Although screening for DRM was reported as being available in 80% of countries surveyed, it was mandatory in only 20% and often poorly implemented. Knowledge of nutritional care was described as inconsistent and specialty-dependent, with 56% reporting access to expert nutrition professionals as limited to hospital settings. Barriers identified included lack of funding, limited workforce availability and nutrition seen as a low priority. Although reimbursement of food for special medical purposes (FSMP) (medical nutrition products for oral or enteral nutrition) was reported by 90% of country respondents it varied by healthcare setting, and 50% reported that obtaining FSMP is ‘difficult/not easy’. Awareness of DRM amongst patients was reported as low, with difficulties navigating complex healthcare systems citied by 70% of country respondents as a key contributing factor to inequity. <h3>Conclusion and Relevance</h3> Knowledge of system-level barriers to nutritional care, beyond HTA, highlights actionable gaps within hospital practice. Hospital pharmacists can act as drivers of change. Through their roles in therapeutic committees, and care coordination, they can help embed medical nutrition into hospital standards and reduce access inequities. <h3>References and/or Acknowledgements</h3> 1. WHO-ESPEN 2023. https://www.who.int/europe/publications/i/item/WHO-EURO-2023-8931-48703-72392 2. Cederholm, <i>et al</i>. 2017. https://www.ncbi.nlm.nih.gov/pubmed/27642056 <h3>Conflict of Interest</h3> Corporate sponsored research or other substantive relationships: MNI represents the companies that were surveyed for this exercise.

During the last decades, there have been increasing concerns in public health debates regarding the production and consumption of red meat, considering connections between the occurrence of nutrition transition and an increase in the prevalence of chronic noncommunicable diseases. The consumption of red meat has been linked to adverse health outcomes; however, current evidence reveals controversies regarding the intake of diverse red meats. In addition, barriers to meat consumption include sanitary legislation linked to foodborne diseases connected to livestock, whilst governments of diverse countries provide incentives for its production and export worldwide. Thus, the objective of the present study was to investigate the evolution in the global trade of processed and unprocessed red meat from 1986 to 2023, using network analysis. Data on the trade of red meat between pairs of 216 countries were obtained from the Food and Agriculture Organization Database (FAOSTAT). The dataset, comprising the mean annual volume of processed and unprocessed red meat exchanged from reporting countries (origin) to partner countries (destination), was used to map global trade networks of red meats and identify global trends in red meat consumption according to country income level. The results indicate substantial intensification in the global trade of processed (0.202 in 1986 to 0.453 kg per capita in 2023) and unprocessed red meat (1.415 in 1986 to 3.315 Kg per capita in 2023). The volume of trade of unprocessed red meat remains greater than the volume processed red meat; yet, the findings indicate a threefold increase in the average weighted degree of processed red meat trade (0.002 to 0.006) from 1986 until 2023, whilst unprocessed red meat showed a twofold increase (0.009 to 0.019). The results raise public health concerns regarding the long-term consequences of consuming processed foods with high sodium and fat content. Additionally, the global trade of red meat showed fluctuations in periods of major foodborne outbreaks related to meat consumption, particularly during the 1990s. The findings of the study highlight strategies at the national level to advance food system transformations towards improvements in public health, nutrition, and sustainability.

Un genre nouveau, le Near Chaos, se déploie actuellement dans la littérature française contemporaine, d’une manière distincte de l’imaginaire spectaculaire des récits apocalyptiques et des représentations des conséquences de l’Anthropocène par les fictions climatiques. Cet article entreprend de cerner les contours de la poétique de ce courant émergent, à partir de l’étude de Tu crèveras comme les autres (2018) de Denis Cheynet, Viendra le temps du feu (2021) de Wendy Delorme, Un peu tard dans la saison (2017) de Jérôme Leroy et Après le monde (2020) d’Antoinette Rychner. L’une des caractéristiques essentielles du Near Chaos est l’établissement d’un lien entre des formes narratives nettement différenciées et des formes d’organisation collectives futures elles-mêmes distinctes : la structure des diégèses est fortement déterminée par des positionnements tranchés en termes de voix, monologisme, dialogisme ou polyphonie. De plus, ces voix constituent ces fictions en autant de laboratoires de pensée et, plus encore, de répertoires d’actions : ne donnant pas la parole au(x) même(s) figures(s), n’étant pas adressées aux mêmes personnages et ne poussant pas à la même réception de la part du lecteur, elles programment chacune un avenir différent.

The integration of artificial intelligence (AI) into medical device software has revolutionized healthcare by enhancing diagnostic accuracy, treatment efficiency, and patient outcomes. However, ensuring the reliability, safety, and regulatory compliance of AI-powered medical devices presents significant challenges. The Good Automated Manufacturing Practice (GAMP 5) guidelines provide a structured framework for validating automated systems, including AI-driven medical software. This study explores the impact of GAMP 5 guidelines on the validation process of AI-powered medical devices, addressing key aspects such as risk management, data integrity, and lifecycle management. Through a detailed analysis of regulatory requirements and case studies, this research highlights best practices for aligning AI-driven medical device validation with GAMP 5 principles. The findings underscore the importance of robust validation methodologies to ensure compliance, improve software performance, and enhance patient safety.