Assessing Market Access: Do Developing Countries Really Get a Preferential Treatment?

This paper provides an assessment of the existing preferences on the products currently exported in a few key developed countries’ markets: EU, Japan and US. The analysis is undertaken drawing on the trade preferences database provided by the most recent version (release 6) of the GTAP database. This includes a presentation of the structure of tariff regimes in these key developed countries and identification of countries and sectors that are most reliant on tariff preferences. The paper computes theoretically consistent protection indexes using a comparative static applied general equilibrium model (Global Trade Analysis Project – GTAP) featuring imperfect competition. We construct bilateral indicators of protection focused on the applied tariffs faced by the exports of each country, using an index of trade policy restrictiveness, the Mercantilistic Trade Restrictiveness Index (MTRI), as the tariff aggregator. Our results provide a picture which is quite different from the one yielded by traditional indexes, such as the trade-weighted tariff average, or market access measures based on bound tariffs.Commercial Policy; Protection; Computable General Equilibrium Models; Agriculture in International Trade.

Impact of Polymorphisms of Gonadotrophins and their receptors on controlled ovarian stimulation

Standard in vitro fertilization (IVF) protocols are characterized by the administration of exogenous follicle stimulation hormone (FSH) which is widely adopted regimen for controlled ovarian stimulation (COS) in normogonadotrophic women. In daily clinical practice, the ovarian response to these protocols are optimal in about 85% of patients, with more than 3 mature oocytes recruited. In about 12-15% of cases, however, an initial low response is seen, leading to an increase in the daily dose of FSH, resulting in a higher total FSH consumption (e.g. >2500 IU) (Alviggi et al., 2013). These observations lead to the development of the concept of “hypo-response” to COS to identify normogonadotrophic women who have normal estimated ovarian reserves but require high amounts of FSH to obtain an adequate number of oocytes retrieved (De Placido et al., 2005, Ferraretti et al., 2004, Devroey et al., 2009). These women seem to be distinct from classical poor responders because they have normal ovarian reserve, but show an unexpected sub-optimal response when stimulated with standard regimens. Conversely, specific adjustments of classical protocols seem to optimise ovarian response (De Placido et al., 2005). On the basis of the current literature, it is possible to argue that hypo-response could be related to genetic characteristics. More specifically, several lines of evidence indicate that this clinical condition may be related to polymorphisms of the genes of gonadotropins and their receptors (Alviggi et al., 2009b, Alviggi et al., 2013). Doctoral research: objectives and sessions The aim of this research project was to exploit the effects of polymorphisms of gonadotropins and their receptors on ovarian response: • The Session A, developed in the first year, is devoted to the results of retrospective analysis concerning the role of FSH-R receptor polymorphism (rs6166). This findings were recently published in a peer review journal (Alviggi et al., 2016b). • The Session B, developed in the second year, is devoted to the results of a prospective analysis in which eight polymorphism of gonadotropins and their receptors were evaluated. Our findings regarding Italian population were recently published in a peer review journal. (Conforti et al., 2017). The preliminary results about all population included were recently published as a supplement in Human Reproduction Journal (Alviggi et al., 2016c). • The Session C developed in the third year of research is devoted to a Systematic Review and Meta-analysis of available worldwide literature data regarding the effect of gonadotropin and their receptors polymorphism on COS. This analysis includes 33 studies and involves more than 4,000 observations. This systematic review was accepted for submission by Human Reproduction Update editorial board which represent the most eminent journal in Obstetrics and Gynaecology (Journal Citation Reports Thomson Reuters

Asymptomatic congenital cystic adenomatoid malformation of the lung: Is it time to operate?

ObjectiveThe optimal management of congenital adenomatoid malformation of the lung remains controversial. Prenatal ultrasonographic analysis has increasingly discovered asymptomatic lesions, raising questions about the need for and timing of surgical treatment for asymptomatic congenital adenomatoid malformation. The aim of our study was to analyze the short-term postoperative outcome of symptomatic congenital adenomatoid malformations compared with asymptomatic malformations.MethodsAll the data of patients presenting with congenital adenomatoid malformations histologically diagnosed and operated on between 1998 and 2005 at our institution were retrospectively reviewed. Patients were divided into 2 groups: group A comprised asymptomatic infants, and group B comprised symptomatic infants. Major outcomes considered were the length of ventilation, pleural drainage, and hospital stay. Postoperative morbidity and mortality were also evaluated. Asymptomatic patients were further stratified for age at the time of the operation to evaluate whether age at surgical intervention affects the outcome. The Fisher's exact and Mann–Whitney tests were used as appropriate.ResultsFifty-seven patients were consecutively treated. Thirty-five patients were given diagnoses of asymptomatic lesions and were enrolled into group A, whereas 22 patients presenting with symptoms were entered into group B. The lengths of ventilation, pleural drainage, and hospital stay were significantly longer in patients with symptomatic congenital adenomatoid malformations. Moreover, symptomatic patients presented with a higher postoperative complication rate. The age-based stratification of asymptomatic children did not show any difference on either postoperative mortality or major outcome considered.ConclusionChildren with congenital adenomatoid malformations operated on when asymptomatic present a better short-term outcome than symptomatic children. In addition, age at the time of the operation does not negatively affect the outcome. Our findings support early surgical treatment for asymptomatic congenital adenomatoid malformation

Telemedicine Network in Pediatric Cardiology: The Case of Tuscany Region in Italy

Four years ago, a telemedicine project in diagnosis and care of congenital cardiac malformations was developed in Tuscany interconnecting the Heart Hospital of Gabriele Monasterio Tuscany Foundation (FTGM) in Massa with main clinical centers around the region. Both live and store-and-forward tele-echocardiography were implemented, while the FTGM medical record system was applied for collaborative reporting. Mobile medical-grade carts, equipped with videoconferencing and computer units, were installed at main neonatology/pediatric centers throughout the Tuscany region. Today, 13 hospitals are connected to the network, while the MEYER Pediatric University Hospital (MEYER) in Firenze has recently adhered to the project, as HUB center jointly with FTGM, so enabling H24 telemedicine service in pediatric cardiology throughout the region. So far, more than 200 patients were diagnosed and followed by telemedicine

Crocus cancellatus subsp. damascenus stigmas: chemical profile, and inhibition of α-amylase, α-glucosidase and lipase, key enzymes related to type 2 diabetes and obesity

Spices are appreciated for their medicinal properties besides their use as food adjuncts to enhance the sensory quality of food. In this study, Crocus cancellatus subsp. damascenus was investigated for its antioxidant activities employing different in vitro systems. Stigma extract demonstrated a radical scavenging activity against both 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid) (ABTS) radicals with IC50 values of 34.6 and 21.6 µg/mL and a good ferric reducing ability (53.9 µM Fe(II)/g). In order to clarify the potential functional properties of this spice, the carbohydrate-hydrolysing enzymes and pancreatic lipase inhibitory properties were investigated. Crocus cancellatus subsp. damascenus extract inhibited α-amylase and α-glucosidase with IC50 values of 57.1 and 68.6 µg/mL, respectively. The bioactivity was discussed in terms of phytochemicals content. The obtained results may be of interest from a functional point of view or as food additive and to promote the revalorization of this species

Luteal Phase Support Using Subcutaneous Progesterone: A Systematic Review

Luteal phase support (LPS) is crucial in assisted reproductive technology (ART) cycles when the luteal phase has been found to be defective. Such deficiency is most likely related to the supraphysiological steroid levels that usually occurr in stimulated cycles which, in turn, could severely affect luteinizing hormone (LH) secretion and function, thereby negatively influencing the luteal phase. A number of different medications and routes have been successfully used for LPS in ART. Although an optimal protocol has not yet been identified, the existing plethora of medications offer the opportunity to personalize LPS according to individual needs. Subcutaneous administration progesterone has been proposed for LPS and could represent an alternative to a vaginal and intramuscular route. The aim of the present systematic review is to summarize the evidence found in the literature concerning the application of subcutaneous progesterone in ARTs, highlighting the benefits and limits of this novel strategy. With this aim in mind, we carried out systematic research in the Medline, ISI Web of Knowledge, and Embase databases from their inception through to November 2020. Randomized controlled trials (RCTs) were preferred by the authors in the elaboration of this article, although case-control and cohort studies have also been considered. According to our findings, evidence exists which supports that, in women with a good prognosis undergoing a fresh in vitro fertilization (IVF) cycle, subcutaneous Pg is not inferior to vaginal products. In the Frozen-thawed embryo transfer (FET) cycle, data concerning efficacy is mixed with an increased miscarriage rate in women undergoing a subcutaneous route in oocyte donor recipients. Data concerning the acceptance of the subcutaneous route versus the vaginal route are encouraging despite the different scales and questionnaires which were used. In addition, a cost-effective analysis has not yet been conducted

Clinical relevance of genetic variants of gonadotrophins and their receptors in controlled ovarian stimulation: a systematic review and meta-analysis

Genotype has been implicated in the outcome of ovarian stimulation. The analysis of patient-specific genotypes might lead to an individualized pharmacogenomic approach to controlled ovarian stimulation (COS). However, the validity of such an approach remains to be established

Biogenic sediments from coastal ecosystems to beach-dune systems: implications for the adaptation of mixed and carbonate beaches to future sea level rise

Coastal ecosystems produce and store carbonate particles, which play a significant role in the carbonate dynamics of coastal areas and may contribute to the sediment budget of adjacent beaches. In the nearshore seabed of temperate zones (e.g. Mediterranean Sea and South Australia), marine biogenic carbonates are mainly produced inside sea-grass meadows. This study quantifies the contribution of biogenic sediments, mainly produced in Posidonia oceanica seagrass meadows and secondarily in photophilic algal communities, to the sediment budget of a Mediterranean beach-dune system (San Giovanni beach, western Sardinia, western Mediterranean Sea). A set of geophysical, petrographic and sedimentological data was used to estimate the sediment volume and composition of the beach-dune system as a whole. The San Giovanni beach-dune system contains 3797000 +/- 404000 t of sediment, 83% (3137000 +/- 404000 t) of which is located in the coastal wedge, 16% (619000 +/- 88000 t) in the dune fields and 1% (41000 +/- 15000 t) in the sub-aerial beach. The sediments are composed of mixed modern bioclastic and relict bioclastic and non-bioclastic grains from various sources. The system receives a large input of modern bioclastic grains, mainly composed of rhodophytes, molluscs and bryozoans, which derive from sediment production of present-day carbonate factories, particularly P. oceanica seagrass meadows. Radiocarbon dating of modern bioclastic grains indicated that they were produced during the last 4.37 kyr. This value was used to estimate the longterm deposition rates of modern bioclastic sediments in the various beach compartments. The total deposition rate of modern bioclastic grains is 46000 +/- 5000 t century 1, mainly deposited in the coastal wedge (39000 +/- 4000 t century(-1)) and dunes (7000 +/- 1000 t century(-1)), and 46 000 t represents similar to 1.2% of the total beach-dune sediment mass. Carbonate production from coastal ecosystems was estimated to be 132000/307000 t century(-1), 28% (15%/34 %) of which is transported to the beach-dune system, thus significantly contributing to the beach sediment budget.The contribution to the beach sediment budget represents a further ecosystem service, which our data can help quantify, provided by P. oceanica. The value of this sediment-supply service is in addition to the other important ecological services provided by seagrass meadows. The dependence of the beach sediment budget on carbonate production associated with coastal ecosystems has several implications for the adaptation of mixed and carbonate beaches to the loss of seagrass meadows due to local impacts and the changes expected to occur over the next few decades in coastal ecosystems following sea level rise

DuoStim – a reproducible strategy to obtain more oocytes and competent embryos in a short time-frame aimed at fertility preservation and IVF purposes. A systematic review

Recent evidence suggests that follicular development occurs in a wave-like model during the ovarian cycle, where up to three cohorts of follicles are recruited to complete folliculogenesis. This understanding overtakes the previous dogma stating that follicles grow only during the follicular phase of the menstrual cycle. Therefore, in in vitro fertilization (IVF), novel protocols regarding ovarian stimulation have been theorized based on the use of gonadotrophins to prompt the growth of antral follicles at any stage of the menstrual cycle. These unconventional protocols for ovarian stimulation aim at a more efficient management of poor-prognosis patients, otherwise exposed to conflicting outcomes after conventional approaches. DuoStim appears among these unconventional stimulation protocols as one of the most promising. It combines two consecutive stimulations in the follicular and luteal phases of the same ovarian cycle, aimed at increasing the number of oocytes retrieved and embryos produced in the short time-frame. This protocol has been suggested for the treatment of all conditions requiring a maximal and urgent exploitation of the ovarian reserve, such as oncological patients and poor responders at an advanced maternal age. At present, data from independent studies have outlined the consistency and reproducibility of this approach, which might also reduce the drop-out between consecutive failed IVF cycles in poor-prognosis patients. However, the protocol must be standardized, and more robust studies and cost-benefit analyses are needed to highlight the true clinical pros and cons deriving from DuoStim implementation in IVF