Exploring the Potential Competition in the Salmon Industry: a Scenario Analysis of Genetically Modified Fish Marketing

Marketing, Resource /Energy Economics and Policy,

Zotarolimus-Eluting Versus Bare-Metal Stents in Uncertain Drug-Eluting Stent Candidates

BACKGROUND The use of drug-eluting stents (DES) in patients at high risk of bleeding or thrombosis has not been prospectively studied; limited data are available in patients who have a low restenosis risk. OBJECTIVES This study sought to compare a hydrophilic polymer-based, second-generation zotarolimus-eluting stent (ZES) with a unique drug fast-release profile versus bare-metal stents (BMS) under similar durations of dual-antiplatelet therapy (DAPT). METHODS We randomly assigned 1,606 patients with stable or unstable symptoms, and who on the basis of thrombotic bleeding or restenosis risk criteria, qualified as uncertain candidates for DES, to receive ZES or BMS. DAPT duration was on the basis of patient characteristics, rather than stent characteristics, and allowed for a personalized 1-month dual antiplatelet regimen. The primary endpoint was the risk of 1-year major adverse cardiovascular events (MACE), which included death, myocardial infarction (MI), or target vessel revascularization (TVR). RESULTS Median DAPT duration was 32 days (interquartile range [IQR]: 30 to 180 days) and did not differ between the groups. In the ZES group, 140 patients (17.5%) reached the primary endpoint, compared with 178 patients (22.1%) in the BMS group (hazard ratio: 0.76; 95% confidence interval: 0.61 to 0.95; p = 0.011) as a result of lower MI (2.9% vs. 8.1%; p < 0.001) and TVR rates (5.9% vs. 10.7%; p = 0.001) in the ZES group. Definite or probable stent thrombosis was also significantly reduced in ZES recipients (2.0% vs. 4.1%; p = 0.019). CONCLUSIONS Compared with BMS, DES implantation using a stent with a biocompatible polymer and fast drug-eluting characteristics, combined with an abbreviated, tailored DAPT regimen, resulted in a lower risk of 1-year MACE in uncertain candidates for DES implantation. (Zotarolimus-eluting Endeavor Sprint Stent in Uncertain DES Candidates [ZEUS] Study; NCT01385319) (C) 2015 by the American College of Cardiology Foundation

Reduced probability of improving viro-immunological state in subjects with vertical transmission of HIV reaching adult age: A multicenter retrospective cohort study

Introduction: Young adults with vertical transmission (VT) of human immunodeficiency virus&nbsp;(HIV) represent a fragile population. This study evaluates factors associated with viro-immunological outcome of these patients. Methods: We performed a multicenter study including HIV-infected subjects with VT ≥ 18 years old from six Italian clinics. Subjects were observed from birth to death, lost to follow-up, or last visit until December 31, 2019. Condition of "optimal viro-immunological status" (OS) was defined as the simultaneous presence of HIV&nbsp;ribonucleic acid&nbsp;(RNA) &lt; 50 copies/mL, CD4+ &gt; 500 cells/mm3 , and CD4+/CD8+ ratio ≥ 1. Results: A total of 126 subjects were enrolled. At 18 years of age, 52/126 (44.4%) had HIV-RNA &gt; 50 copies/mL, 47/126 (38.2%) had CD4+ &lt; 500/mm3 , and 78/126 (67.2%) had&nbsp;CD4+/CD8+ &lt; 1; 28 subjects (23.7%) presented in the condition of OS. Having a CD4+/CD8+ ratio ≥ 1 at 18 years of age was related with an increased probability of shift from suboptimal viro-immunological status (SOS) to OS (HR: 7.7, 95% confidence interval [CI]: 4.23-14.04), and a reduced risk of shift from the OS to the SOS (HR: 0.49, 95% CI: 0.26-0.92). Acquired immunodeficiency syndrome (AIDS) diagnosis significantly reduced the probability of shift from a viro-immunological SOS to OS (HR: 0.09, 95% CI:&nbsp;0.03-0.30). Subjects who had not achieved an OS at 18 years of age had an increased risk of discontinuation of combination antiretroviral therapy (cART, p = .019). Conclusions: Only a small proportion of subjects with VT of HIV reached the adult age with "OS".&nbsp;Transition to the adult care with a compromised viro-immunological condition represents a negative driver for future optimal infection control, with a higher risk of discontinuation of cART and a reduced probability to improve the immunological status later in the years

Freezing of gait in Parkinson’s disease patients treated with bilateral subthalamic nucleus deep brain stimulation: A long-term overview

Bilateral subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment in advanced Parkinson’s Disease (PD). However, the effects of STN-DBS on freezing of gait (FOG) are still debated, particularly in the long-term follow-up (&gt;/=5-years). The main aim of the current study is to evaluate the long-term effects of STN-DBS on FOG. Twenty STN-DBS treated PD patients were included. Each patient was assessed before surgery through a detailed neurological evaluation, including FOG score, and reevaluated in the long-term (median follow-up: 5-years) in different stimulation and drug conditions. In the long term follow-up, FOG score significantly worsened in the off-stimulation/off-medication condition compared with the preoperative off-medication assessment (z = -1.930; p = 0.05) but not in the on-stimulation/off-medication (z = -0.357; p = 0.721). There was also a significant improvement of FOG at long-term assessment by comparing on-stimulation/off-medication and off-stimulation/off-medication conditions (z = -2.944; p = 0.003). These results highlight the possible beneficial long-term effects of STN-DBS on FOG

Freezing of Gait in Parkinson's Disease Patients Treated with Bilateral Subthalamic Nucleus Deep Brain Stimulation: A Long-Term Overview

Bilateral subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment in advanced Parkinson's Disease (PD). However, the effects of STN-DBS on freezing of gait (FOG) are still debated, particularly in the long-term follow-up (≥5-years). The main aim of the current study is to evaluate the long-term effects of STN-DBS on FOG. Twenty STN-DBS treated PD patients were included. Each patient was assessed before surgery through a detailed neurological evaluation, including FOG score, and revaluated in the long-term (median follow-up: 5-years) in different stimulation and drug conditions. In the long term follow-up, FOG score significantly worsened in the off-stimulation/off-medication condition compared with the pre-operative off-medication assessment (z = -1.930; p = 0.05) but not in the on-stimulation/off-medication (z = -0.357; p = 0.721). There was also a significant improvement of FOG at long-term assessment by comparing on-stimulation/off-medication and off-stimulation/off-medication conditions (z = -2.944; p = 0.003). These results highlight the possible beneficial long-term effects of STN-DBS on FOG

Genetically modified salmon for dinner? : transgenic salmon marketing scenarios

Increasing demand for fish must be satisfied sustainably, and genetically modified (GM) fish will probably be part of the solution. This article aims to describe the future trends in the salmon-farming sector and the potential effects of GM salmon introduction on the salmon industry. We have developed a qualitative scenario analysis based on a literature review and expert consultation (n=14). The majority of experts consulted do not believe that GM salmon introduction will be an important technical innovation. Nevertheless, three experts did agree that GM salmon would enter the market in the near future. This would cause new regulations to be introduced, reduce market price, make farmers more dependent on input suppliers, and pose risks to the environment. We used a cross-impact method to create three scenarios: 1) no market for GM fish, 2) GM salmon for dinner, and 3) GM salmon doesn't take off. The article describes the effects on the salmon industry under each scenario

Valutazione dell’aterosclerosi coronarica mediante tomografia computerizzata multistrato in pazienti con infarto miocardico acuto in assenza di coronaropatia critica: confronto con l’angiografia coronarica quantitativa

Premessa: E’ noto che tra i pazienti con infarto miocardico acuto (IMA) una percentuale variabile tra il 4 ed il 31% non presenta alterazioni coronariche significative all’angiografia. Questi pazienti costituiscono una sfida sia diagnostica che terapeutica per il cardiologo. La tomografia computerizzata (TC) multistrato può identificare la presenza di malattia aterosclerotica coronarica anche in assenza di stenosi coronariche significative. Lo scopo di questo studio è di valutare il ruolo della TC a 64 strati, a confronto con l’angiografia coronarica, nell’individuare e caratterizzare l’aterosclerosi coronarica nei pazienti con infarto miocardico acuto in assenza di stenosi coronariche significative. Metodi e Risultati: La popolazione dello studio è costituita da 30 pazienti consecutivi con diagnosi di infarto miocardico acuto ma senza stenosi coronariche significative alla coronarografia e sottoposti durante il ricovero a TC a 64 strati. Tutti i segmenti coronarici sono stati sottoposti ad analisi quantitativa sia angiografica (CA-QCA) sia mediante TC (CT- QCA). I valori medi dei diametri di riferimento prossimali misurati con CT- QCA e CA-QCA sono risultati rispettivamente 2.88±0.75 mm e 2.65±0.9 mm; la correlazione tra CT-QCA e CA-QCA per la quantificazione dei diametri di riferimento è stata rs=0.77; P<0.001. La percentuale media di stenosi è risultata di 14.4±8.0% mediante CT-QCA e di 4.0±11.0% mediante CA-QCA con un grado di correlazione tra le metodiche pari a rs=0.11; P=0.03. La CT-QCA ha identificato la presenza di 50 placche coronariche (delle quali solo 11 individuate anche mediante CA-QCA), 25 delle quali presenti nell’arteria correlata all’infarto. In 38 placche su 50 (76%) era presente rimodellamento positivo. Conclusioni: La CT-QCA, a confronto con il gold standard rappresentato dalla CA-QCA, mostra un buona correlazione per quanto riguarda l’analisi dei diametri di riferimento coronarici, ma non per la quantificazione delle stenosi coronariche. Tuttavia la CT a 64-strati può identificare la presenza di placche aterosclerotiche che sfuggono alla angiografia coronarica e può pertanto avere un valore incrementale nella diagnosi di infarto miocardico acuto in pazienti senza alterazioni coronariche significative all’angiografia