Equity and efficiency aspects of Italian debt reduction

This paper examines the distributional and efficiency effects of different debt reduction schemes in Italy. To finance a given deficit reduction path, we introduce the so-called Eurotax and endogenously adjust either the consumption tax rate or lump-sum transfers in order to balance the budget. The analysis is based on a numerically specified overlapping generations model of the Auerbach-Kotlikoff type which distinguishes five different lifetime in-come classes within each age cohort. Our simulations suggest that the debt reduction in Italy will increase the welfare of future generations between 1 and 3 per cent of their lifetime resources. Mainly this is due to the implied reduction in future net tax burdens. However, factor price repercussions as well as efficiency gains might also be substantiaüy beneficial to future generations. Finally, while the Eurotax is clearly progressive, consumption taxation is revealed to be, at least in our model, regressive even in the long run

Who bears the burden of debt reduction in Italy?

In this paper we ask who bears the burden of recent deficit reduction schemes in Italy. We implemented a reduction of the public deficit to 3 per cent of the GDP, the value that would allow Italy to meet the Maastricht Treaty criteria. The cut-down is financed by the so-called Eurotax (introduced temporarily or permanently), combined with an adjustment of the consumption tax rate or, alternatively, of lump-sum transfers, which are endogenously calculated to balance the budget. The policy reforms are simulated in a small open economy, with firms facing adjustment costs in the investment technology. The quantitative analysis is based on a numerically specified overlapping generations model of the Auerbach-Kotlikoff (AK) type. The traditional framework is extended by distinguishing between five different lifetime income classes within each age cohort. After each policy reform, we decompose the total individual welfare effects into their efficiency and redistributional components. This makes it possible to compare the implied intergenerational income effects and the efficiency effects quantitatively. Our simulations suggest that the debt reduction in Italy will increase the welfare of the future generations betwpen 1 and 2 per cent of their lifetime resources. The main reason is the implied reduction in the future net tax burdens. In order to sustain an upper deficit limit of 3 per cent of GDP permanently, an increase in consumption taxes rather than the Eurotax would be preferable

Synergistic Bcl-2 inhibition by ABT-737 and cyclosporine A

Survival of lymphocytes and melanocyte stem cells critically depends on B cell lymphoma 2 (Bcl-2). In T lymphocytes, a basal calcineurin activity maintains Bcl-2 expression in naïve cells, and the activation of the calcineurin pathway orchestrates the regulation of the intrinsic apoptosis pathway after antigen recognition. Therefore, calcineurin inhibitors might potentiate the pro-apoptotic effect of pharmacological Bcl-2 inhibitors on lymphatic cells. In vitro, a reduced Bcl-2 expression in lymphocytes exposed to calcineurin inhibitors increased their sensitivity to the small molecule Bcl-2 inhibitor ABT-737. This correlated with an augmented pro-apoptotic activity of ABT-737 on lymphocytes in combination with cyclosporine A in naïve mice in vivo. Interestingly, similar processes were observed in melanocytes. ABT-737 induced a fur depigmentation at the site of injection, and this effect was expanded to a generalized depigmentation in combination with cyclosporine A. Thus, inhibiting calcineurin increases the pro-apoptotic potency of ABT-737 in cells depending on Bcl-2 for survival. The increased efficacy of Bcl-2 inhibitors in combination with cyclosporine A might be relevant to exploit their anti-neoplastic and immuno-modulatory propertie

Ready-To-Go Questionnaire - Development and validation of a novel medical pre-travel risk stratification tool

Background There are no validated pre-travel self-assessment tools to stratify travellers' health risks and identify their needs for pre-travel medical preparation. This study presents a novel pre-travel risk stratification tool (Ready-To-Go Questionnaire). Methods The Ready-To-Go Questionnaire was developed by travel medical experts. It assesses information on travellers' itinerary and current health status, thereby assigning travellers to one out of four risk categories. To explore the Ready-To-Go Questionnaire's validity, we analysed the agreement between the risk categories resulting from the questionnaire and predefined validation criteria. This study was carried out at the Travel Clinic, University of Zurich, Switzerland. Results One hundred travellers attending a pre-travel consultation were included. 82% corresponded to the substantial-risk category, 17% to the high-risk category, 1% to the moderate-risk category and 0% to the low-risk category. The concordance between the risk categories and the consultants' risk assessment, was 0.39 and 0.29 (unweighted/weighted Cohen's Kappa). No significant concordance was found between the risk categories and additional validation criteria. Conclusion The Ready-To-Go Questionnaire is a medical triage tool developed to identify different levels of travel-related health risks. This tool assists in better understanding travellers' needs, shaping modern travel consultations and offering patient-centred travel medicine services

Investigation on Laser Micro Ablation of Steel Using Short and Ultrashort IR Multipulses

Investigations on laser micro ablation of steel have been made using multipulses instead of single pulses. The aim is to improve the efficiency of laser micro ablation by increasing the ablation rate and quality at the same time. For the improvement of the multipulse laser ablation a flash-lamp pumped Nd:YAG laser with 20 to 100 ns pulse duration is used which can supply multipulses with a specially triggered pockels cell at 10 Hz. A mayor increase of ablation by distribution of energy on several pulses is observed. Further investigations have been made with a commercial ps laser system with a pulse duration of 12 ps at a repetition rate of 100 kHz. The used bursts consisted of up to four pulses with interpulse separations Δt between 20 ns and 100 µs. A cut-off frequency ν cut-off up to which the double pulse ablation equals single pulse ablation is defined by plasma enhanced absorption of the second laser pulse. For the comparison of multipulse and single pulse ablation the geometry and the roughness of the irradiated area have been detected by white light interference microscopy

The Ready-To-Go Questionnaire predicts health outcomes during travel: a smartphone application-based analysis

BACKGROUND The Ready-To-Go (R2G) Questionnaire is a tool for rapid assessment of health risks for travel consultation. This study aims to assess the utility of the R2G Questionnaire in identifying high-risk travellers and predicting health events and behaviour during travel in the TOURIST2 prospective cohort. METHODS TOURIST2 data were used to calculate the R2G medical and travel risk scores and categorize each participant based on their risk. The TOURIST2 study enrolled 1000 participants from Switzerland's largest travel clinics between 2017 and 2019. Participants completed daily smartphone application surveys before, during and after travel on health events and behaviours. We used regression models to analyse incidence of overall health events and of similar health events grouped into health domains (e.g. respiratory, gastrointestinal, accident/injury). Incidence rate ratios (IRR) are displayed with 95% confidence intervals (95% CI). RESULTS R2G high-risk travellers experienced significantly greater incidence of health events compared to lower-risk travellers (IRR = 1.27, 95% CI: 1.22-1.33). Both the medical and travel scores showed significant positive associations with incidence of health events during travel (IRR = 1.11, 95% CI: 1.07-1.16; IRR = 1.07, 95% CI: 1.03-1.12, respectively), with significant increases in all health domains except skin disorders. Medical and travel risk scores were associated with different patterns in behaviour. Travellers with chronic health conditions accessed medical care during travel more often (IRR = 1.16, 95% CI: 1.03-1.31), had greater difficulty in carrying out planned activities (IRR = -0.04, 95% CI: -0.05, -0.02), and rated their travel experience lower (IRR = -0.04, 95% CI: -0.06, -0.02). Travellers with increased travel-related risks due to planned travel itinerary had more frequent animal contact (IRR = 1.09, 95% CI: 1.01-1.18) and accidents/injuries (IRR = 1.28, 95% CI: 1.15-1.44). CONCLUSIONS The R2G Questionnaire is a promising risk assessment tool that offers a timesaving and reliable means to identify high-risk travellers. Incorporated into travel medicine websites, it could serve as a pre-consultation triage to help travellers self-identify their risk level, direct them to the appropriate medical provider(s), and help practitioners in giving more tailored advice

Virological outcome of patients with HIV drug resistance attending an urban out-patient clinic in Uganda: a need for structured adherence counselling and third line treatment options

BACKGROUND HIV drug resistance and suboptimal adherence are the main reasons for treatment failure among HIV-infected individuals. As genotypic resistance testing is not routinely available in resource-limited settings such as Uganda, data on transmitted and acquired resistance is sparse. METHODS This observational follow-up study assessed the virological outcomes of patients diagnosed with virological failure or transmitted HIV drug resistance in 2015 at the adults' out-patient clinic of the Infectious Diseases Institute in Kampala, Uganda. Initially, 2430 patients on antiretroviral therapy (ART) underwent virological monitoring, of which 190 had virological failure and were subsequently eligible for this follow-up study. Nine patients diagnosed with transmitted drug resistance were eligible. In patients with a viral load > 1000 copies/mL genotypic resistance testing was done. RESULTS Of 190 eligible patients, 30 (15.8%) had either died or were lost to follow-up. A total of 148 (77.9%) were included, of which 98 had had a change of ART regimen, and 50 had received adherence counselling only. The majority was now on 2-line ART (N=130, 87.8%). The median age was 39 years (interquartile range: 32-46) and 109 (73.6%) were female. Virological failure was diagnosed in 29 (19.6%) patients, of which 24 (82.8%) were on 2-line ART. Relevant drug resistance was found in 25 (86.2%) cases, of which 12 (41.3%) carried dual and 7 (24.1%) triple drug resistance. CONCLUSION Two years after initial virological failure, most patients followed up by this study had a successful virological outcome. However, a significant proportion either continued to fail or died or was lost to follow-up

The value of genome-wide analysis in craniosynostosis

Background: This study assessed the diagnostic yield of high-throughput sequencing methods in a cohort of craniosynostosis (CS) patients not presenting causal variants identified through previous targeted analysis.Methods: Whole-genome or whole-exome sequencing (WGS/WES) was performed in a cohort of 59 patients (from 57 families) assessed by retrospective phenotyping as having syndromic or nonsyndromic CS.Results: A syndromic form was identified in 51% of the unrelated cases. A genetic cause was identified in 38% of syndromic cases, with novel variants detected in FGFR2 (a rare Alu insertion), TWIST1, TCF12, KIAA0586, HDAC9, FOXP1, and NSD2. Additionally, we report two patients with rare recurrent variants in KAT6A and YY1 as well as two patients with structural genomic aberrations: one with a 22q13 duplication and one with a complex rearrangement involving chromosome 2 (2p25 duplication including SOX11 and deletion of 2q22). Moreover, we identified potentially relevant variants in 87% of the remaining families with no previously detected causal variants, including novel variants in ADAMTSL4, ASH1L, ATRX, C2CD3, CHD5, ERF, H4C5, IFT122, IFT140, KDM6B, KMT2D, LTBP1, MAP3K7, NOTCH2, NSD1, SOS1, SPRY1, POLR2A, PRRX1, RECQL4, TAB2, TAOK1, TET3, TGFBR1, TCF20, and ZBTB20.Conclusion: These results confirm WGS/WES as a powerful diagnostic tool capable of either targeted in silico or broad genomic analysis depending on phenotypic presentation (e.g., classical or unusual forms of syndromic CS)

Ability to Work and Employment Rates in Human Immunodeficiency Virus (HIV)-1-Infected Individuals Receiving Combination Antiretroviral Therapy: The Swiss HIV Cohort Study.

Background.  Limited data exist on human immunodeficiency virus (HIV)-infected individuals' ability to work after receiving combination antiretroviral therapy (cART). We aimed to investigate predictors of regaining full ability to work at 1 year after starting cART. Methods.  Antiretroviral-naive HIV-infected individuals <60 years who started cART from January 1998 through December 2012 within the framework of the Swiss HIV Cohort Study were analyzed. Inability to work was defined as a medical judgment of the patient's ability to work as 0%. Results.  Of 5800 subjects, 4382 (75.6%) were fully able to work, 471 (8.1%) able to work part time, and 947 (16.3%) were unable to work at baseline. Of the 947 patients unable to work, 439 (46.3%) were able to work either full time or part time at 1 year of treatment. Predictors of recovering full ability to work were non-white ethnicity (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.20-3.54), higher education (OR, 4.03; 95% CI, 2.47-7.48), and achieving HIV-ribonucleic acid <50 copies/mL (OR, 1.83; 95% CI, 1.20-2.80). Older age (OR, 0.55; 95% CI, .42-.72, per 10 years older) and psychiatric disorders (OR, 0.24; 95% CI, .13-.47) were associated with lower odds of ability to work. Recovering full ability to work at 1 year increased from 24.0% in 1998-2001 to 41.2% in 2009-2012, but the employment rates did not increase. Conclusions.  Regaining full ability to work depends primarily on achieving viral suppression, absence of psychiatric comorbidity, and favorable psychosocial factors. The discrepancy between patients' ability to work and employment rates indicates barriers to reintegration of persons infected with HIV