Search

Policy Analysis Matrix Applied to the Study of Tunisian Sugar Industry (. Before 1962 Tunisia depended completely on foreign markets for its needs in sugar. The installation in the north-western region of two transformation units had two objectives ; the first was to produce part of the sugar consumed locally the second was the need to introduce sugar beet crop to equilibrate the rotation plans in the new irrigated perimeters. The present paper use the policy analysis matrix PAM to show that Tunisia does not have comparative advantage in the production of sugar and that to maintain current level of production it is necessary for the government to subsidize farmers and processors and to assume a social loss because of the misallocation of resources.

Aims To evaluate the safety, efficacy and long-term actuarial results of balloon mitral commissurotomy in young patients with severe rheumatic mitral stenosis.Methods and results Event-free survival and freedom from restenosis were analyzed in 110 patients 20 years old or younger (group 1) and compared with those of 554 adults (group 2). Young patients were less frequently in atrial fibrillation (6% vs 35%, P<0.001) and had less mitral valve deformities (echo score 5.9±2.1 vs 7.5±3.0, P<0.0001). Mitral valve area index by 2D-echo was of 0.66±0.1cm2/m2in group 1 and 0.67±0.1cm2/m2in group 2 (P=ns) and was larger in group 1 (1.5 vs 1.3cm2/m2) after the procedure (P<0.0001). There were more complications in group 2 (8.4% vs 0%, P=0.01). Procedural success was obtained in 110 (100%) patients of group 1 vs 501 (92%) patients of group 2 (P<0.0001). At follow-up mitral valve area index was 1.34cm2/m2in group 1 and 1.16cm2/m2in group 2 (P<0.0001). At 10 years, freedom from restenosis was 61% in group 1 vs 71% in group 2 (P=0.35) and event-free survival was 74% and 69% respectively (P=0.15).Conclusion Balloon mitral commissurotomy is safe and effective in young with rheumatic mitral stenosis and provides better immediate results than in adults. However long-term outcome was similar between the 2 groups: 2/3 of patients were alive and free from clinical events at 10 years. [ABSTRACT FROM PUBLISHER]

Previous studies have indicated serious impacts of current market organization on the distribution of fresh fish and consequently on the prevalent pricing system leading to high inter-regional price differences and lack of market integration. The primary area of inquiry in this study relates to market integration as a proxy for spatial pricing efficiency. The Law of One Price (LOP) analysis was used to test whether prices in pairs of markets are integrated through transfer costs or not. The findings of this study have practical policy implications indicating that the current marketing system for fish in Oman is not supporting a fair distribution of returns from fisheries operations to all participants in the sector. [ABSTRACT FROM PUBLISHER]

Background: Granulocyte-macrophage colony-stimulating factor (GM-CSF) and dysregulated myeloid cell responses are implicated in the pathophysiology and severity of COVID-19., Methods: In this randomised, sequential, multicentre, placebo-controlled, double-blind study, adults aged 18-79 years (Part 1) or ≥70 years (Part 2) with severe COVID-19, respiratory failure and systemic inflammation (elevated C-reactive protein/ferritin) received a single intravenous infusion of otilimab 90 mg (human anti-GM-CSF monoclonal antibody) plus standard care (NCT04376684). The primary outcome was the proportion of patients alive and free of respiratory failure at Day 28., Results: In Part 1 (n=806 randomised 1:1 otilimab:placebo), 71% of otilimab-treated patients were alive and free of respiratory failure at Day 28 versus 67% who received placebo; the model-adjusted difference of 5.3% was not statistically significant (95% CI -0.8-11.4%, p=0.09). A nominally significant model-adjusted difference of 19.1% (95% CI 5.2-33.1%, p=0.009) was observed in the predefined 70-79 years subgroup, but this was not confirmed in Part 2 (n=350 randomised) where the model-adjusted difference was 0.9% (95% CI -9.3-11.2%, p=0.86). Compared with placebo, otilimab resulted in lower serum concentrations of key inflammatory markers, including the putative pharmacodynamic biomarker CC chemokine ligand 17, indicative of GM-CSF pathway blockade. Adverse events were comparable between groups and consistent with severe COVID-19., Conclusions: There was no significant difference in the proportion of patients alive and free of respiratory failure at Day 28. However, despite the lack of clinical benefit, a reduction in inflammatory markers was observed with otilimab, in addition to an acceptable safety profile., Competing Interests: Conflict of interest: J. Patel, D. Bass, A. Cahn, K. Davy, S. Fernandes, A. Gupta, K. Hanrott, D. Inman, E. Jarvis, D. Lakshminarayanan, S. Mukherjee, C. O'Shea, L. Schifano, J.E. Smith, R. Williamson and M. Layton are shareholders and/or employees of GSK. A. Beishuizen, X. Bocca Ruiz, H. Boughanmi, H. Colombo, G.J. Criner, J. de-Miguel-Díez, P.A. Doreski, B. François, T. Hatlen, J.D. Isaacs, N. Kostina, T. Kropotina, J-C. Lacherade, P. Martinez-Ayala, C. McEvoy, F. Meziani, M. Monchi, R. Muñoz-Bermúdez, G. Plantefeve, L.E. Schwab, Z. Shahid, M. Shirano, E. Sprinz, C. Summers, N. Terzi and Y. Trefilova were investigators in the OSCAR trial, which was funded by GSK. X. Bocca Ruiz has served as a clinical trial investigator for AstraZeneca and Zambon. B. François reports consultancy fees with GSK, Enlivex, Inotrem, Takeda, Aridis, Transgene, AM-Pharma, Asahi-Kasai and Biomérieux within the past 36 months. R. Muñoz-Bermúdez has participated on an advisory board for GSK. J.D. Isaacs has received research funding from GSK, Janssen and Pfizer, and personal fees from AbbVie, BMS, Gilead, Roche and UCB, all outside the submitted work, as well as support for event attendance from Eli Lilly and Gilead. A. Beishuizen has received consultancy fees from GSK. C. McEvoy has received research funding from the National Institutes of Health, US Department of Defense, Patient-Centered Outcomes Research Institute, GSK and AstraZeneca. C. Summers’ institution has received research funding from GSK, AstraZeneca, the Wellcome Trust, The Medical Research Council and National Institute for Health Research to support her work outside the area of the submitted manuscript. C. Summers has received personal fees from AbbVie, Roche and GSK. G.J. Criner has received research grants from ALung Technologies Inc., American College of Radiology, American Lung Associations, AstraZeneca, BioScale Inc., Boehringer Ingelheim, BREATH Therapeutics Inc., COPD Foundation, Coridea/ZIDAN, Corvus, Dr Karen Burns of St Michael's Hospital, Fisher & Paykel Healthcare Ltd, Galapagos NV, GSK, Kinevent, Lungpacer Medical Inc., National Heart Lung and Blood Institute, Nurvaira Inc., Patient-Centered Outcomes Research Institute, Pulmonary Fibrosis Foundation, PulmonX, Respironics Inc., Respivant Sciences, Spiration Inc., Steward St Elizabeth's Medical Center of Boston Inc. and Veracyte Inc.; and received personal fees from Amgen, AstraZeneca, Boehringer Ingelheim, Broncus Medical, CSA Medical, EOLO Medical, Gala Therapeutics, GSK, Helios Medical, Ion, Merck, Medtronic, Mereo BioPharma, NGM Biopharmaceuticals, Novartis, Olympus, PulmonX, Respironics Inc., Respivant Sciences, The Implementation Group and Verona Pharma. J. Neisen is an employee and shareholder of AstraZeneca, and a shareholder and former employee of GSK. L.E. Schwab reports holding shares in Johnson & Johnson and BMS, and participated on the Holy Cross Health Institutional Review Board. Z. Shahid has received research funding from Karyopharm. M. Shirano is an investigator in separate trials funded by Roche and AstraZeneca, and has received payment for lectures from Gilead Sciences. E. Sprinz participates on a data safety monitoring board/advisory board for, and has received consulting fees and honoraria from, GSK, Janssen and Gilead. M.A. Tidswell received a fee for serving on the independent data monitoring committee for this study, as well as for serving on a data safety monitoring board/advisory board for Spectral Diagnostics Inc., ReAlta Life Sciences Inc., Celltrion Inc., AstraZeneca and Molecular Partners AG. Additionally, M.A. Tidswell has held a research contract with Edesa Biotech Research Inc., RevImmune SAS, Spectral Diagnostics, Beyond Air Inc., National Institutes of Health and National Heart, Lung, and Blood Institute. D. Wyncoll received a fee for serving on the independent data monitoring committee for this study, has served as a study adjudicator for AstraZeneca, and reports consulting fees and/or honoraria from Gilead and Shionogi. J. de-Miguel-Díez, H. Boughanmi, J-C. Lacherade, P. Martinez-Ayala, T. Hatlen, G. Plantefeve, N. Terzi, M. Shirano, N. Kostina, T. Kropotina, Y. Trefilova and M. Monchi have no other conflicts of interest to declare., (Copyright ©The authors 2023.)

Background and Aim of the Study: Controversy persists as to whether atrial fibrillation (AF) has a direct negative effect on the outcome of percutaneous balloon mitral commissurotomy (PBMC). The study aim was to assess the effect of AF on immediate and 10-year clinical and echocardiographic actuarial results of patients with rheumatic mitral stenosis undergoing PBMC., Methods: A total of 195 consecutive patients with AF (group 1) was analyzed and compared with 195 patients in sinus rhythm (group 2), matched for the severity of mitral valve morphological changes., Results: Group 1 patients were older (43.8 + 12 versus 30.5 +/- 12.7 years; p <0.001), and a greater proportion had grade 1 mitral regurgitation (25.1 versus 9.7%; p <0.0001). The procedural success was 89.8% in group 1 and 92.3% in group 2 (p = NS), but group 1 patients had a smaller mitral valve area (2.1 +/- 0.4 versus 2.3 +/- 0.4 cm2; p <0.0001). Patients in AF had a lower 10-year survival (91.4 versus 99.4%; p = 0.018), a lower 10-year event-free-survival (60.3 versus 70%; p = 0.02), and a lower 10-year freedom from restenosis (40 versus 66%; p = 0.048). AF was an independent predictor of overall mortality (OR = 10.79; p <0.033) and of combined events (death, redo PBMC or mitral valve surgery; OR = 1.95; p <0.012), and was a univariate predictor of restenosis (p = 0.048)., Conclusion: Patients with AF have good immediate results, but poorer long-term outcome after PBMC. AF a marker of worse prognosis in patients with mitral stenosis as it is in the general population.

Unlabelled: The aim of our study was to identify predictor factors of coronary ischemic events to stratify the risk. 367 patients, mean age 59 years (22-90), 288 men (88%), Coronary risk factors: Smoking (62%), diabetes (38%), hypertension (37%), hypercholesterolemia (18%). BRAUNWALD class III was predominant (60%). Electrocardiographic changes were present in 113 patients. Coronary angiography identified: 148 single-vessel disease, 92 double-vessel and 68 triple-vessel. In the hospital phase, 296 patients (80.5%) were stabilised. 65 had recurrent ischemia (17.5%), 6 myocardial infarction (1.5%) and 6 deaths (1.5%). After multivariate logistic regression the predictors factors of ischemic events were. Age > or = 65 years (p = 0.03), coronary artery bypass grafting (p = 0.05), left ventricular failure (p = 0.024), modified baseline electrocardiogram (p = 0.04), ST-segment depression (p = 0.05), without aspirin (p = 0.043) and heparin (p = 0.047). At 6 months, 181 patients were asymptomatic (59.1%), 101 had recurrent ischemia (33%), 14 myocardial infarction (4.6%) and 10 deaths (3.3%). After multivariate analysis, the predictor factors were: Age > or = 65 years (p = 0.026), previous unstable angina (p = 0.023), left main stenosis (p = 0.008) and without aspirin (p = 0.003)., Conclusion: Our study identified a subgroup of high risk patients who would benefit most from either low-molecular-weight heparins and Glycoprotein IIb/IIIa receptor blockers with an early revascularisation strategy.