Market Access

The negotiation of improved market access in agriculture is crucial to the success of the Doha Round. The depth of tariff cuts will be the main indication of the level of ambition of the agricultural talks and hence the Round as a whole. Agricultural tariffs remain five times higher than tariffs in industrial goods, and account for the bulk of the distortions in agricultural trade. Recent analysis indicates that 92 percent of the global gains from trade liberalization in agriculture result from removing market access barriers. The July Framework reaffirmed the objective of substantial improvements in market access. This is to be accomplished by a single approach, a tiered (or banded) formula for tariff cuts, with the higher tariff rates being subject to the highest cuts. Negotiations have centered on how many bands to select, where to place the thresholds, and how progressive to make the band-specific reductions. The issue of whether to impose a tariff cap was left undecided in the Framework Agreement. Tariff caps have the advantage of reducing tariffs that are so high that they are little different from an import ban. If the cap is set at a low enough level, real trade improvements may follow. The Framework Agreement specifies that each Member may identify in the schedule a number of products as "Sensitive Products." However, analysis has shown that even exempting as little as two percent of tariff lines from formula based cuts would substantially reduce the expected gains from market access improvements. This points up the need for significant increases in TRQs for Sensitive Products to achieve significant improvements in market access. All tariff lines subject to TRQs, whether or not they are classified as Sensitive Products, should be subject to quota volume expansion. Improving the administration of TRQs and reducing in-quota tariffs are both important objectives for the Doha Round. There is considerable scope to improve the efficiency and transparency of quota regimes. The continued availability of the Special Safeguard for Agriculture by WTO members "remains under negotiation." But abuse of such a safeguard in order to protect domestic producers thwarts the objective of improved market access. Some limitations will need to be introduced if the safeguard is to be continued under the new agreement. The Framework Agreement emphasizes that Special and Differential Treatment is to be an integral part of the market access outcome. This can be ensured by several provisions. Developing countries can specify a number of products as Special Products, based on criteria of food security, livelihood security and rural development needs. The difficulty is in devising concrete criteria for selecting these products. The Framework Agreement also endorses the creation of a Special Safeguard Mechanism for developing countries. Tariff cuts in the Doha Round can erode the value of preferences and can have important consequences for some countries. Preference-granting countries could offset the declining value of those preferences either through financial transfers or additional market access for all products from the current preferred exporters. Least Developed Countries (LDCs) should not be required to undertake any reduction commitments, though they might wish to do so for their own economic advantage. Developed countries should provide duty- and quota-free access to LDCs to encourage full integration into the trade system.International Relations/Trade,

Is contrast-enhanced US alternative to spiral CT in the assessment of treatment outcome of radiofrequency ablation in hepatocellular carcinoma?

Purpose: The present study was conducted to assess the efficacy of contrast-enhanced ultrasound with low mechanical index in evaluating the response of percutaneous radiofrequency ablation treatment of hepatocellular carcinoma by comparing it with 4-row spiral computed tomography. Materials and Methods: 100 consecutive patients (65 men and 35 women; age range: 62 – 76 years) with solitary hepatocellular carcinomas (mean lesion diameter: 3.7cm± 1.1cm SD) underwent internally cooled radiofrequency ablation. Therapeutic response was evaluated at one month after the treatment with triple-phasic contrast-enhanced spiral CT and low-mechanical index contrast-enhanced ultrasound following bolus injection of 2.4 ml of Sonovue (Bracco, Milan). 60 out of 100 patients were followed up for another 3 months. Contrast-enhanced sonographic studies were reviewed by two blinded radiologists in consensus. Sensitivity, specificity, NPV and PPV of contrast-enhanced ultrasound examination were determined. Results: After treatment, contrast-enhanced ultrasound identified persistent signal enhancement in 24 patients (24%), whereas no intratumoral enhancement was detected in the remaining 76 patients (76%). Using CT imaging as gold standard, the sensitivity, specificity, NPV, and PPV of contrast enhanced ultrasound were 92.3% (95% CI = 75.9 – 97.9%), 100% (95% CI = 95.2 – 100%), 97.4% (95% CI = 91.1 – 99.3%), and 100% (95% CI = 86.2 – 100%). Conclusion: Contrast-enhanced ultrasound with low mechanical index using Sonovue is a feasible tool in evaluating the response of hepatocellular carcinoma to radiofrequency ablation. Accuracy is comparable to 4-row spiral CT

Prime valutazioni degli effetti della protezione sull’ittiofauna di fondo roccioso nella costa occidentale dell’Isola dell’Asinara = Preliminary evaluation of the effects of protection on rocky fish assemblages in the Western coast of Asinara Island

Coastal fish fauna from a recently established Mediterranean MPA and from an adjacent nonprotected zone near its boundary were compared to evaluate the effects of protection. A remarkable “reserve effect” was detected for the whole assemblage in terms of both species richness and abundance. Moreover, a moderate spillover effect outside the MPA was observed for several target species

Variazioni spazio-temporali della fauna ittica nelle pozze di scogliera del litorale di Budoni (Sardegna Nord Orientale) = Spatio-temporal variations of ichthyofauna in the tidal rockpools from the Coast of Budoni (North Eastern Sardinia)

Fish fauna of tidal pools was investigated in a coastal district of Sardinia (central western Mediterranean) between October 2007 and October 2008. Overall, 206 specimens from 7 species belonging to 5 families were recorded in two groups of tidal pools with a different coastal exposure. Significant differences in the number of individuals were detected for tidal pools differently exposed, while number of species, number of individuals, and biomass were significantly different among the sampling periods

Eating Disorders: Assessment of Knowledge on a Dentist’s Sample

Aim: To analyze the knowledge and experience of dentists with private practices in the Sassari district with regard to eating disorders and clinical stomatology manifestations. Methods: A questionnaire to investigate dentists’ knowledge and experience was created and submitted to a random sample of dentists. Data were collected and analysed using the Stata SE 10 software. Results: In total, 150 dentists were enrolled (a representative sample). After questionnaire evaluation, the following results were obtained: 80.7% (121) of the participants had a degree in dentistry and 19.3% (29) had degrees in medicine with a dentistry master of science diploma, 46% (69) were males and 54% (81) were females, their age range was 25-62 (mean, 36.1) years, and the average work experience was 11.5 (range, 1-36) years. More than 90% of the participants defined eating disorders only as bulimia and anorexia. Of the dentists, 77.3% (116) correctly identified Western populations as the most affected, whereas 52.7% identified only whites as the most affected people. In total, 80% of the dentists recognised dental erosion and abrasion as typical oral manifestations. Only 62% stated that salivary pH decreases in these conditions, and 63% did not recognise parotid gland tumefaction as a clinical sign. Regarding operator experience, 60.7% (91 dentists) had clinical experience of patients with eating disorders: 43.9% of them had made diagnoses from oral manifestations, 51.3% (77) were not able to treat these patients, and 69.3% (104) would refer patients to specialized centres for treatment. Moreover, 119 (79.3%) considered that a dental hygienist was a valid collaborator for the treatment of oral cavity manifestations. Regarding prophylaxis, 16.7% (25) suggested fluoride prophylaxis and 21.3% (32) oral hygiene education. Only 1.3% indicated the use of bicarbonate to change salivary pH values, suggested conservative or prosthetic restorations, suggested the use of saliva substitutes, or the sealing of permanent teeth. Difficulties in clinically treating these patients were related to a lack of knowledge for 72% (108) of participants. Of them, 36.7% (55) had studied the clinical aspects of this pathology while attending dental school and 24.7% (37) after their degree. In total, 94.7% (142) expressed the need for further information and only 2% (3) considered they had sufficient clinical knowledge. Conclusions: It is evident that there is a lack of knowledge regarding the problem and there would seem to be an urgent need to provide more training programs and to establish guidelines for the diagnosis and treatment of eating disorders among dentists. In our opinion, the acquisition of such knowledge will change the approach to related pathology, improving clinical skills, and subsequently diagnosis and treatment

Morphometric relationships and annual gonad index of the edible Sea urchin <i>Paracentrotus lividus</i> from North Western Sardinia = Relazioni morfometriche e indice gonadico annuale del riccio di mare commestibile <i>Paracentrotus lividus</i> nel nord ovest Sardegna

Weight/diameter, weight/height and height/diameter morphometric relationships were calculated for a shallow rocky Paracentrotus lividus population sampled monthly near Alghero (Italy) from November 2004 to October 2005. Gonad index (GI) of the sea urchins was also evaluated. Statistical analyses showed significant differences of GI between 2 distinct periods of the year: late fall-winter and spring-late summer

Biophysical and biological characterization of a new line of hyaluronan-based dermal fillers: A scientific rationale to specific clinical indications

Chemico-physical and biological characterization of hyaluronan-based dermal fillers is of key importance to differentiate between numerous available products and to optimize their use. These studies on fillers are nowadays perceived as a reliable approach to predict their performance in vivo. The object of this paper is a recent line of hyaluronic acid (HA)-based dermal fillers, Aliaxin®, available in different formulations that claim a complete facial restoration. The aim of the study is to provide biophysical and biological data that may support the clinical indications and allow to predict performance possibly with respect to similar available products. Aliaxin® formulations were tested for their content in soluble HA, water uptake capacity, rheological behavior, stability to enzymatic degradation, and for in vitro capacity to stimulate extracellular matrix components production. The formulations were found to contain a low amount of soluble HA and were equivalent to each other regarding insoluble hydrogel concentration. The different crosslinking degree declared by the producer was consistent with the trend in water uptake capacity, rigidity, viscosity. No significant differences in stability to enzymatic hydrolysis were found. In vitro experiments, using a full thickness skin model, showed an increase in collagen production in the dermoepidermal junction. Results support the claims of different clinical indications, the classification of products regarding hydro-, lift-action and the specifically suggested needle gauge for the delivery. The biological outcomes also support products effectiveness in skin structure restoration. These data predicted a better performance regarding hydro-action, tissue integration, clinical management during delivery, and a high durability of the aesthetic effect when compared to data on marketed similar products

Arthrocentesis and temporomandibular joint disorders: clinical and radiological results of a prospective study

Purpose. We evaluated the efficacy of arthrocentesis in the treatment of temporomandibular joint (TMJ) disorders. Material and Methods. In this prospective clinical case series, 30 consecutive patients with TMJ disorders underwent arthrocentesis using saline and sodium hyaluronate injections. Outcome measures were TMJ pain, maximum mouth opening (MMO), joint noises, and anatomical changes in the TMJ architecture. Patients were evaluated using cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) at the beginning of treatment and 60 days after the last arthrocentesis. Pretreatment and posttreatment clinical parameters were compared using paired and unpaired t-tests, and McNemar’s test was used to evaluate CBCT and MRI changes (P &lt; 0.05). Results. At 1-year follow-up examinations, visual analogue scale scores indicated that pain was reduced significantly and mean postoperative MMO was increased significantly. CBCT findings showed no significant change, and MRI showed only slight reductions in inflammatory signs. Conclusions. Within the limitations of this study, we can conclude that arthrocentesis is a simple, minimally invasive procedure with a relatively low risk of complications and significant clinical benefits in patients with TMJ disorders. This trial is registered with NCT01903512 [http://clinicaltrials.gov/show/NCT01903512]

Vertiginous crisis following temporomandibular joint athrocentesis: a case report

Temporomandibular joint arthrocentesis and arthroscopy have recently exceeded open surgeries for disorders that failed to respond to conservative treatment. The efficacy of arthrocentesis in reestablishing normal mouth opening and reducing pain and dysfunctions is now commonly accepted, but in contrast to arthroscopy, there are no large series studies on arthrocentesis complications. We report the major complication occurred in our experience: a case of a patient that complained of a violent vertigo, without hearing disorders, following the procedure