Investment, insurance and weather shocks: Evidence from Cambodia

The livelihoods of poor people in developing countries are increasingly dependent on weather shocks whose effects are exacerbated by the lack of access to adequate insurance markets allowing risk hedging. Index-based insurance underwrites a weather risk as a proxy for economic loss: when the index falls below a certain level, farmers automatically get a payment. The aim of this paper is to study the impact of an Index-based insurance on investment decisions in profitable but risky inputs in presence of weather shocks by means of an incentivized lab-in-the-field experiment conducted in Cambodia. The protocol is designed so as to study the extent to which investment decisions change under risk or ambiguity, for different levels of initial wealth, under contract nonperformance (i.e., when claims are not repaid by the insurer) and when the insurance is fully subsidized. The findings indicate that, while the mere presence of a market for insurance increases investment, the strength of the effect crucially depends upon the level of initial wealth and upon the subjects' ability to correctly assess the probability of a shock

Induction of Labor According to Medical Indications: A Critical Evaluation through a Prospective Study

Background: The induction of labor (IOL) is a common obstetric intervention, steadily increasing (one out four pregnancies) in the last years. This procedure should be considered only when there is a medical indication, and when the benefits outweigh the maternal and/or fetal risks of waiting for spontaneous onset of labor. Therefore, this study aims to compare the efficacy of the IOL in terms of induction to delivery time, mode of delivery, and neonatal well-being among different evidence-based and non-evidence-based indications. Methods: This prospective study was conducted at the University Hospital of Modena, between January and December 2020. We included singleton pregnant women undergoing IOL, at the term. Intrauterine deaths, small for gestational age fetuses <5th centile as well women with hypertensive disorders were excluded. Women have been subdivided into 3 groups based on the indication to IOL: premature rupture of membranes (PROM), post-date pregnancy (>41 weeks + 3 days), and non-evidence-based indications (NEBI). The primary outcome is the time occurring between IOL and delivery (TIME), analyzing separately by parity. Moreover, mode of delivery and neonatal wellbeing were evaluated. Results: A total of 585 women underwent IOL in the study period. Overall, the median TIME between IOL and delivery was 19 hours, and the mean cesarean section CS rate was 15.5% (91/585). Pregnancies induced for postdate and non-evidencebased indications registered respectively a significantly higher mean time (p < 0.001), compared with women induced for PROM. This occurred both in nulliparous and multiparous women. Moreover, at multivariate analysis, the IOL TIME ≥24 hours was significantly influenced by Bishop score (p = 0.000) and NEBI (p = 0.02) in nulliparous and by gestational age (p = 0.000) and NEBI (p = 0.02) in multiparous. Moreover, CS rate was significantly influenced by Bishop score (p = 0.003) in nulliparous and by gestational age (p = 0.01) in multiparous. Finally, neonatal intensive care unit (NICU) admission resulted significantly influenced only by gestational age (p = 0.002) in multiparous. Conclusions: Our study confirms that IOL in non-evidence-based indications, leads to an increase in induction to delivery time comparing with women induced for PROM, both in nulliparous and multiparous women, thus it should be justified and carefully evaluated. Further randomized controlled trials (RCT) conducted in European/Italian settings are needed to determine the perinatal outcomes of IOL in non-evidence-based indications

Recoil Proton Telescopes and Parallel Plate Avalanche Counters for the 235^{235}U(n,f) cross section measurement relative to H(n,n)H between 10 and 450 MeV neutron energy

With the aim of measuring the $^{235}$U(n,f) cross section at the n\_TOF facility at CERN over a wide neutron energy range, a detection system consisting of two fission detectors and three detectors for neutron flux determination was realized. The neutron flux detectors are Recoil Proton Telescopes (RPT), based on scintillators and solid state detectors, conceived to detect recoil protons from the neutron-proton elastic scattering reaction. This system, along with a fission chamber and an array of parallel plate avalanche counters for fission event detection, was installed for the measurement at the n\_TOF facility in 2018, at CERN. An overview of the performances of two RPTs - especially developed for this measurement - and of the parallel plate avalanche counters are described in this article. In particular, the characterization in terms of detection efficiency by Monte Carlo simulations and response to neutron beam, the study of the background, dead time correction and characterization of the samples, are reported. The results of the present investigation show that the performances of these detectors are suitable for accurate measurements of fission reaction cross sections in the range from 10 to 450~MeV

Action of MK‐7264 (Gefapixant) at human P2X3 and P2X2/3 receptors and in vivo efficacy in models of sensitisation

Background & Purpose The P2X3 receptor is an ATP‐gated ion channel expressed by sensory afferent neurons, and is as a target to treat chronic sensitisation conditions. The first‐in‐class, selective P2X3 and P2X2/3 receptor antagonist, the diaminopyrimidine MK‐7264 (Gefapixant), has progressed to Phase III trials for refractory or unexplained chronic cough. We have used patch‐clamp to elucidate the pharmacology and kinetics of MK‐7264 and rat models of hypersensitivity and hyperalgesia to test efficacy in these conditions. Experimental Approach Whole‐cell patch‐clamp of 1321N1 cells expressing human P2X3 and P2X2/3 receptors was used to determine mode of MK‐7264 action, potency and kinetics. The analgesic efficacy was assessed using paw withdrawal threshold and limb weight distribution in rat models of inflammatory, osteoarthritic and neuropathic sensitisation. Key Results MK‐7264 is a reversible allosteric antagonist at human P2X3 and P2X2/3 receptors with IC50 values of 153 and 220nM, respectively. Experiments with the slowly desensitising P2X2/3 heteromer revealed concentration and state‐dependency to wash‐on, with faster rates and greater inhibition when applied before agonist compared to during agonist application. Wash‐on rate (τ value) for MK‐7264 at maximal concentrations was 19s and 146s when applied before and during agonist application, respectively. In vivo, MK‐7264 (30 mg/kg) displayed efficacy comparable to naproxen (20 mg/kg) in inflammatory and osteoarthritic sensitisation models, and gabapentin (100 mg/kg) in neuropathic sensitisation models, increasing paw withdrawal threshold and decreasing weight bearing discomfort. Conclusions and Implications MK‐7264 is a reversible and selective P2X3 and P2X2/3 antagonist, exerting allosteric antagonism via preferential activity at closed channels. Efficacy in rat models supports clinical investigation of chronic sensitisation conditions