Felicita e mercato nel pensiero di Adam Smith

Del pensiero di Adam Smith analizzeremo soprattutto gli aspetti etici ed antropologici legati al modo di strutturarsi della società intorno al modo di produzione capitalistico. Le tre classi che la compongono (proprietari terrieri, mercanti e manifattori, lavoratori salariati) riflettono una disuguaglianza sociale che, nell'idea di Smith, il mercato può colmare a livello distributivo, garantendo il minimo di sussistenza a tutti. Tuttavia, l'interazione della psicologia e dei comportamenti individuali con gli scambi di mercato ha degli effetti diversi in base al contesto in cui si produce e non sempre gli effetti positivi di un'economia di mercato sono così evidenti. In particolar modo, la felicità e l'interesse pubblico, se appiattiti sulla logica dei bisogni soddisfacibili dal mercato, rischiano di perdere ogni connotazione politica, e di svuotare perciò le funzioni dello stato della loro finalità collettiva

Interregional migration of human creative capital:The case of "Bohemian graduates"

The human capital endowment has long been perceived to be of paramount importance to regional growth and development. In recent years, there also has been a widely held belief that creativity, going hand in hand with innovation and knowledge creation, readily translates into regional competitiveness. Attracting quality human capital and cultivating creative industry/class have been given an unprecedented level of significance in regional policies. As a result of this, understanding the factors determining the migration behaviour of graduates – and especially graduates in creative disciplines – has clear implications for policy makers. In addressing these issues and advancing our understanding of the relationship between creativity and mobility in human capital, this study provides the first empirical analysis of the role played by graduates' subject background (i.e. creative vs. non-creative subjects) in influencing their migration choice in the UK. Our data employed in this paper primarily draw on the Destinations of Lea-vers from Higher Education Survey (DLHE) 2006/2007, collected by the UK's Higher Education Statistic Agency. Graduates are classified into five migration categories based on their migration choices from domicile to university and then onto workplace. Our results show that graduates from disciplines such as business/management and more importantly engineering/technology are more migratory and more likely to be repeat migrants and land higher paid jobs, while graduates from creative arts, education or law are less mobile and, on average, earn less

Potential of Biofermentative Unsulfated Chondroitin and Hyaluronic Acid in Dermal Repair

Chondroitin obtained through biotechnological processes (BC) shares similarities with both chondroitin sulfate (CS), due to the dimeric repetitive unit, and hyaluronic acid (HA), as it is unsulfated. In the framework of this experimental research, formulations containing BC with an average molecular size of about 35 KDa and high molecular weight HA (HHA) were characterized with respect to their rheological behavior, stability to enzymatic hydrolysis and they were evaluated in different skin damage models. The rheological characterization of the HHA/BC formulation revealed a G' of 92 ± 3 Pa and a G″ of 116 ± 5 Pa and supported an easy injectability even at a concentration of 40 mg/mL. HA/BC preserved the HHA fraction better than HHA alone. BTH was active on BC alone only at high concentration. Assays on scratched keratinocytes (HaCaT) monolayers showed that all the glycosaminoglycan formulations accelerated cell migration, with HA/BC fastening healing 2-fold compared to the control. In addition, in 2D HaCaT cultures, as well as in a 3D skin tissue model HHA/BC efficiently modulated mRNA and protein levels of different types of collagens and elastin remarking a functional tissue physiology. Finally, immortalized human fibroblasts were challenged with TNF-α to obtain an in vitro model of inflammation. Upon HHA/BC addition, secreted IL-6 level was lower and efficient ECM biosynthesis was re-established. Finally, co-cultures of HaCaT and melanocytes were established, showing the ability of HHA/BC to modulate melanin release, suggesting a possible effect of this specific formulation on the reduction of stretch marks. Overall, besides demonstrating the safety of BC, the present study highlights the potential beneficial effect of HHA/BC formulation in different damage dermal models

Body mass index and treatment response to subcutaneous abatacept in patients with psoriatic arthritis: a post hoc analysis of a phase III trial

Objective: This post hoc analysis of the phase III Active PSoriaTic Arthritis RAndomizEd TriAl (ASTRAEA) evaluated the effect of baseline body mass index (BMI) on subsequent response to subcutaneous (SC) abatacept in patients with psoriatic arthritis (PsA). Methods: In ASTRAEA, patients with active PsA were randomised (1:1) to receive blinded weekly SC abatacept 125 mg or placebo for 24 weeks. Treatment response at week 24 was assessed by the proportions of patients achieving American College of Rheumatology 20% improvement response, Disease Activity Score in 28 joints (DAS28 (C reactive protein (CRP))) ≤3.6 and <2.6, Health Assessment Questionnaire-Disability Index reduction from baseline ≥0.35 and radiographic non-progression (defined as change from baseline ≤0 in PsA-modified total Sharp/van der Heijde score). Responses were stratified by baseline BMI (underweight/normal, <25 kg/m2; overweight, 25–30 kg/m2; obese, >30 kg/m2) and compared in univariate and multivariate models. Results: Of 212/213 and 210/211 patients with baseline BMI data in the abatacept and placebo groups, respectively, 15% and 19% were underweight/normal, 36% and 27% were overweight, and 49% and 54% were obese. After adjusting for baseline characteristics, there were no significant differences for any outcome measure at week 24 with abatacept in the overweight or obese versus underweight/normal subgroup. In the placebo group, patients in the obese versus underweight/normal subgroup were significantly less likely to achieve DAS28 (CRP) <2.6 at week 24 (OR 0.26; 95% CI 0.08 to 0.87; p=0.03). Conclusion: BMI does not impact clinical or radiographic response to SC abatacept in patients with PsA

Silent acro-osteolysis in a patient with psoriatic disease and recurrent micro-trauma

A 42-year-old woman with a 15-year history of psoriatic disease with skin, nail and joint involvement presented for routine follow-up visit. The patient did not complain of relevant articular symptoms, physical examination was unremarkable excepted for feet nail onychodystrophy and routine laboratory tests were unaltered

Intensive training programme for ultrasound-guided minimally invasive synovial tissue biopsy on knees and wrists in different phases of inflammation

Objectives: To develop an intensive training programme for ultrasound (US)-guided synovial tissue (ST) biopsy on knees and wrists in inflammatory arthritis and to assess the learning curve, patient tolerability, sample quality and trainees’ expectations. Methods: Active or remission rheumatoid arthritis patients were enrolled. Nine trainees joined the 4-month programme in a centre experienced in performing US-guided ST biopsies consisting of four sequential phases: (1) observation, (2) performance of guided step-by-step phases, (3) execution of the whole procedure on paired joints (knees or wrists) of the same patient in parallel with the trainer and (4) performance of the procedure autonomously. Sample representativity was assessed by histology, and procedure-related adverse events were recorded. Before and after the programme, trainees’ expectations and perceptions were collected. Results: 328 ST biopsy procedures were included. The rate of trainees’ informative samples was: (1) comparable to the trainers in active and remission knees, but lower in active wrists (70% for trainees vs 100% for trainers, p=0.06) in phase 3; (2) excellent on active knees and wrists (91.9% and 90.9% respectively) but lower (77.6%, p=0.0089) on remission knees in phase 4. Procedures performed by trainees did not affect patient tolerability. Trainees’ expectations about procedure-related invasiveness and pain infliction decreased while the difficulty of procedure execution on active wrists and remission knees remained perceived as moderately difficult. Conclusions: This intensive training programme develops advanced skills in the performance of US-guided ST biopsy on knees and wrists, yielding high-quality specimens available for basic and translational studies on inflammatory joint diseases

Measurement properties of radiographic outcome measures in Psoriatic Arthritis:A systematic review from the GRAPPA-OMERACT initiative

Background Structural damage is as an important outcome in the Psoriatic Arthritis (PsA) Core Domain Set and its assessment is recommended at least once in the development of a new drug. Objectives To conduct a systematic review (SR) to identify studies addressing the measurement properties of radiographic outcome instruments for structural damage in PsA and appraise the evidence through the Outcome Measures in Rheumatology (OMERACT) Filter 2.1 Framework Instrument Selection Algorithm (OFISA). Methods A SR was conducted using search strategies in EMBASE and MEDLINE to identify full-text English studies which aimed to develop or assess the measurement properties of radiographic outcome instruments in PsA. Determination of eligibility and data extraction was performed independently by two reviewers with input from a third to achieve consensus. Two reviewers assessed the methodology and results of eligible studies and synthesized the evidence using OMERACT methodology. Results Twelve articles evaluating radiographic instruments were included. The articles assessed nine peripheral (hands, wrists and/or feet) and six axial (spinal and/or sacroiliac joints) radiographic instruments. The peripheral radiographic instruments with some evidence for reliability, cross-sectional construct validity and longitudinal construct validity were the Ratingen and modified Sharp van der Heijde scores. No instruments had evidence for clinical trial discrimination or thresholds of meaning. There was limited evidence for the measurement properties of all identified axial instruments. Conclusion There are significant knowledge gaps in the responsiveness of peripheral radiographic instruments. Axial radiographic instruments require further validation, and the need to generate novel instruments and utilise other imaging modalities should be considered

Response to Secukinumab on Synovitis using Power Doppler Ultrasound in Psoriatic Arthritis: 12-week Results from a Phase III Study, ULTIMATE

Objectives: To investigate the dynamics of response of synovitis to interleukin (IL)-17A inhibition with secukinumab in patients with active psoriatic arthritis (PsA) using Power Doppler ultrasound. Methods: The randomised, placebo-controlled, Phase III ULTIMATE study enrolled PsA patients with active ultrasound synovitis, and clinical synovitis and enthesitis having an inadequate response to conventional disease-modifying anti-rheumatic drugs (DMARDs) and naïve to biologic DMARDs. Patients were randomly assigned to receive either weekly subcutaneous secukinumab (300 or 150 mg according to the severity of psoriasis) or placebo followed by 4-weekly dosing thereafter. The primary outcome was the mean change in the ultrasound Global European League Against Rheumatism and Outcome Measures in Rheumatoid Arthritis Clinical Trials Synovitis Score (GLOESS) from baseline to week 12. Key secondary endpoints included American College of Rheumatology 20 and 50 responses. Results: Of the 166 patients enrolled, 97% completed 12 weeks of treatment (secukinumab, 99%; placebo, 95%). The primary end point was met, and the adjusted mean change in GLOESS was higher with secukinumab than placebo (-9 [0.9] vs -6 [0.9], difference [95% CI]: -3 [-6; -1]; one-sided p = 0.004) at week 12. The difference in GLOESS between secukinumab and placebo was significant as early as one week after initiation of treatment. All key secondary endpoints were met. No new or unexpected safety findings were reported. Conclusion: This unique ultrasound study shows that apart from improving the signs and symptoms of PsA, IL-17A inhibition with secukinumab leads to a rapid and significant reduction of synovitis in PsA patients. Keywords: Clinical outcome; GLOESS; Joints; OMERACT; Power Doppler ultrasound; PsA; Responsiveness; Secukinumab; Synovitis; biological DMARDs

Adult-onset Still's disease following COVID-19 vaccination

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Practice of ultrasound-guided arthrocentesis and joint injection, including training and implementation, in Europe: results of a survey of experts and scientific societies

Objectives. To document the practice and training opportunities of US-guided arthrocentesis and joint injection (UGAJ) among rheumatologists in the member countries of the European League Against Rheumatism (EULAR). Methods. An English-language questionnaire, containing questions on demographics, clinical and practical aspects of UGAJ, training options in UGAJ for rheumatologists, UGAJ education in the rheumatology training curriculum and other structured education programmes in UGAJ was sent to three different groups: (i) all national rheumatology societies of EULAR; (ii) all national societies of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB); and (iii) 22 senior rheumatologists involved in EULAR musculoskeletal US training from 14 European countries, who were also asked to circulate the questionnaire among relevant colleagues. Results. Thirty-three (75%) of 44 countries responded to the questionnaire (61.3% of national rheumatology societies, 25% of the national US societies and 100% of expert ultrasonographers). In the majority of countries (85%) 80%) rate of rheumatologists performing conventional joint injection in most of the surveyed countries. The reported variations in practice and the lack of available structured training programmes for trainees in most countries indicates the need for standardization in areas including training guideline