Sales promotions and channel coordination

Consumer sales promotions are usually the result of the decisions of two marketing channel parties, the manufacturer and the retailer. In making these decisions, each party normally follows its own interest: i.e. maximizes its own profit. Unfortunately, this results in a suboptimal outcome for the channel as a whole. Independent profit maximization by channel parties leads to a lack of channel coordination with the implication of leaving money on the table. This may well contribute to the notoriously low profitability of sales promotions. This paper first shows analytically why the suboptimality occurs, and then presents an empirical demonstration, using a unique dataset from an Efficient Consumer Response (ECR) project; ECR is a movement in which parties work together to optimize the distribution channel). In this dataset, actual profit is only a small fraction of potential profit, implying that there is a large degree of suboptimality. It is important that (1) channel parties are aware of this suboptimality; and (2) that they have tools to deal with it. Solutions to the channel coordination problem should ensure that the goals of the individual channel parties are aligned with the goals of the channel as a whole. The paper proposes one particular agreement for this purpose, called proportional discount sharing. Application to the ECR data shows a win-win result for both the manufacturer and the retailer. Recognition of the channel coordination problem by the manufacturer and the retailer is the necessary starting point for agreeing on a way of solving it in a win-win fashion

The distinctive gastric fluid proteome in gastric cancer reveals a multi-biomarker diagnostic profile

<p>Abstract</p> <p>Background</p> <p>Overall gastric cancer survival remains poor mainly because there are no reliable methods for identifying highly curable early stage disease. Multi-protein profiling of gastric fluids, obtained from the anatomic site of pathology, could reveal diagnostic proteomic fingerprints.</p> <p>Methods</p> <p>Protein profiles were generated from gastric fluid samples of 19 gastric cancer and 36 benign gastritides patients undergoing elective, clinically-indicated gastroscopy using surface-enhanced laser desorption/ionization time-of-flight mass spectrometry on multiple ProteinChip arrays. Proteomic features were compared by significance analysis of microarray algorithm and two-way hierarchical clustering. A second blinded sample set (24 gastric cancers and 29 clinically benign gastritides) was used for validation.</p> <p>Results</p> <p>By significance analysyis of microarray, 60 proteomic features were up-regulated and 46 were down-regulated in gastric cancer samples (<it>p </it>< 0.01). Multimarker clustering showed two distinctive proteomic profiles independent of age and ethnicity. Eighteen of 19 cancer samples clustered together (sensitivity 95%) while 27/36 of non-cancer samples clustered in a second group. Nine non-cancer samples that clustered with cancer samples included 5 pre-malignant lesions (1 adenomatous polyp and 4 intestinal metaplasia). Validation using a second sample set showed the sensitivity and specificity to be 88% and 93%, respectively. Positive predictive value of the combined data was 0.80. Selected peptide sequencing identified pepsinogen C and pepsin A activation peptide as significantly down-regulated and alpha-defensin as significantly up-regulated.</p> <p>Conclusion</p> <p>This simple and reproducible multimarker proteomic assay could supplement clinical gastroscopic evaluation of symptomatic patients to enhance diagnostic accuracy for gastric cancer and pre-malignant lesions.</p

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Cornelia de Lange syndrome: description of the orofacial features and case report.

Cornelia de Lange Syndrome (CdLS) is a very rare syndrome characterised by multiple congenital anomaly affecting various organs and severe mental retardation. Incidence has been reported to be 1: 10.000-20.000 among the general population, with no racial predilection. The aetiology is still unknown but researchers, in 2004, discovered a mutation of the NIPBL gene located on chromosome 5 which is considered to be responsible of the disease. The main clinical features of the syndrome regard distinctive facial features, severe growth retardation, developmental and mental delay, hirsutism, structural limb abnormalities. The authors describe the main features of the syndrome focusing on oral and facial malformations and report a case of a three years old patient with CdLS

Two cases of familial hypomagnesemia with hypercalciuria and nephrocalcinosis: dental findings.

The authors describe dental and periodontal conditions of two Chinese sisters affected by familial hypomagnesemia with hypercalciuria and nefrocalcinosis (FHHNC). FHHNC is a rare syndrome, genetically investigated since 1999, transmitted as an autosomal recessive disease. It is related to a mutation of PCN-1 gene which encodes for a tight junction protein named paracellin. CASE REPORT: Oral examination of two Chinese patients showed marked enamel hypoplasia, acute gingivitis and periodontal bone loss and severe malocclusion. The literature does not report previous investigations about the dental conditions of FHHNC patients. The syndrome is not definitely described from the clinical point of view. CONCLUSION: Further researches are necessary to understand the linkage between bone loss and enamel structure anomalies in FHHNC and to discover the relationships between nefrocalcinosis, hypomagnesemia, hypercalciuria and amelogenesis imperfecta.Background The authors describe dental and periodontal conditions of two Chinese sisters affected by familial hypomagnesemia with hypercalciuria and nefrocalcinosis (FHHNC). FHHNC is a rare syndrome, genetically investigated since 1999, transmitted as an autosomal recessive disease. It is related to a mutation of PCN-1 gene which encodes for a tight junction protein named paracellin. Case report Oral examination of two Chinese patients showed marked enamel hypoplasia, acute gingivitis and periodontal bone loss and severe malocclusion. The literature does not report previous investigations about the dental conditions of FHHNC patients. The syndrome is not definitely described from the clinical point of view. Conclusion Further researches are necessary to understand the linkage between bone loss and enamel structure anomalies in FHHNC and to discover the relationships between nefrocalcinosis, hypomagnesemia, hypercalciuria and amelogenesis imperfecta

Dente natale e inquinamento ambientale: un\u2019ipotesi eziopatogenetica

Sono definiti neonatali i denti presenti alla nascita o la cui eruzione avvenga durante il primo mese di vita. La prevalenza di questa evidenza clinica varia tra 1:700 e 1: 30.000. L\u2019elemento dentale maggiormente interessato \ue8 l\u2019incisivo centrale inferiore e, nella maggior parte dei casi, non si tratta di un elemento sovrannumerario. Diversi Autori descrivono l\u2019associazione dente tra neonatale e numerose sindromi genetiche tra le quali le pi\uf9 frequenti sono rappresentate dalla sindrome di Jadasshon-Lewandowsky, di Ellis-Van Creveld, di Hallerman-Streiff, di Pierre-Robin e di Soto. Recentemente si \ue8 riscontrato un aumento di incidenza di tale evento, che \ue8 stato messo in relazione a fattori ambientali ed in particolare all\u2019esposizione a sostanze tossiche quali il policlorinato bifenile (PCB). Questa molecola \ue8 utilizzata nella produzione di vernici industriali e di liquidi refrigeranti e viene liberata nell\u2019atmosfera per combustione incompleta della plastica. Presenta una tossicit\ue0 acuta e cronica; attraversando la barriera transplacentare ,sono stati descritti diversi effetti sul feto, tra i quali eruzione anticipata dei denti decidui, iperpigmentazione della cute, delle mucose e delle unghie, calcificazioni occipito-parietali ed incompleta chiusura delle suture craniche, edema faciale ed esoftalmo. Nel corso dell\u2019anno 2003 sono afferiti presso il Servizio di Assistenza odontoiatrica per Disabili, cinque bambini di et\ue0 compresa tra 5 e 60 giorni, in cui un elemento dentale inferiore era gi\ue0 presente alla nascita. Tutti gli elementi dentali presentavano mobilit\ue0 di grado 3, che ne rendeva necessaria l\u2019estrazione perch\ue9 a rischio di ingestione accidentale durante la suzione. L\u2019aumento di incidenza di questa evidenza clinica porta ad ipotizzare una correlazione tra dente neonatale ed esposizione a sostanze tossiche da inquinamento ambiental

Lesioni dentali di origine traumatica in soggetti disabili in et\ue0 evolutiva.

I soggetti disabili rappresentano una categoria di pazienti ad elevato rischio di lesioni dentali di origine traumatica. Queste lesioni sono di frequente riscontro all\u2019anamnesi, sono potenziali responsabili di danno di tipo estetico e funzionale, comportano problematiche terapeutiche, in molti casi sono sottostimate, in altri hanno importanti ripercussioni psicologiche sulla famiglia. Fattori predisponenti locali di frequente riscontro sono patologie ortopedico-ortodontiche (in particolare aumento dell\u2019overjet), lesioni cariose, parodontopatie profonde. Fattori predisponenti sistemici sono handicap motori, ritardi mentali, epilessie, difetti visivi. Obiettivo di questa indagine epidemiologica \ue8 descrivere la gestione delle lesioni dentali di origine traumatica in pazienti disabili in et\ue0 pediatrica afferiti al Servizio di assistenza odontoiatrica per disabili dell\u2019Universit\ue0 di Bologna. Sono state esaminati i dati relativi a 283 pazienti disabili giunti ad osservazione in un periodo di due anni. L\u2018analisi dei dati evidenzia come le lesioni dentali presentino alcune specificit\ue0 rispetto alla restante popolazione.Per quanto concerne le terapie, sulla base di motivazioni etiche, le linee guida sono le stesse da utilizzare nella restante popolazione, con particolare attenzione agli elementi del settore frontale, in considerazione dell\u2019importanza dell\u2019estetica nel favorire l\u2019integrazione sociale di questi soggetti

Pain and anxiety control in Down syndrome

Authors describe most recent techniques in anxiety and pain control in Down Syndrome patients. Physical and psychological considerations are factors that determine the choice of methods. Down Syndrome represents one of the most frequent genetic diseases causing mental and physical impairment and because of crescent deinstitutionalisation and social opportunities these patients often require dental treatment. Pain control represents one of the most important aspects in therapeutical approach to obtain patient compliance, considering that oral health is the result of continuing relationship between dentist and patient. Congenital heart and neurological diseases are to be carefully considered in choosing a pain control technique. Local anaesthesia together with psychological approach is always the first choice and other techniques are reserved to non collaborative patients and to cases needing one step therapy. However conscious and deep sedation and general anaesthesia required hospital environment and the presence of an anaesthesiologist to monitorize vital parameters