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We measured the perception of competition in the market for essential and orphan drugs. The inflation rate for original products was 0.002 annually, whereas that for generic drugs was 0.005. The province of Panama, containing 46.5 % of private pharmacies, has the lowest index in the perception of competition; 18 % of the respondents to the out-of-pocket expenditure survey did not have drugs available, and 55 % could not afford them. The Gini coefficients were 0.40 (2014) and 0.76 (2017). The increase in prices, the relative independence of retailers to establish prices, and low access to social/private insurance increase the out-of-pocket expenses.

We measured the perception of competition in the market for essential and orphan drugs. The inflation rate for original products was 0.002 annually, whereas that for generic drugs was 0.005. The province of Panama, containing 46.5 % of private pharmacies, has the lowest index in the perception of competition; 18 % of the respondents to the out-of-pocket expenditure survey did not have drugs available, and 55 % could not afford them. The Gini coefficients were 0.40 (2014) and 0.76 (2017). The increase in prices, the relative independence of retailers to establish prices, and low access to social/private insurance increase the out-of-pocket expenses.

We measured the perception of competition in the market for essential and orphan drugs. The inflation rate for original products was 0.002 annually, whereas that for generic drugs was 0.005. The province of Panama, containing 46.5% of private pharmacies, has the lowest index in the perception of competition; 18% of the respondents to the out-of-pocket expenditure survey did not have drugs available, and 55% could not afford them. The Gini coefficients were 0.40 (2014) and 0.76 (2017). The increase in prices, the relative independence of retailers to establish prices, and low access to social/private insurance increase the out-of-pocket expenses.

Medimos la percepción de competencia en el mercado de medicamentos esenciales y huérfanos. La tasa de inflación de los productos originales fue de 0.002 anuales, mientras que la de los medicamentos genéricos fue de 0.005. La provincia de Panamá, que contiene el 46.5 % de las farmacias privadas, tiene el índice más bajo en la percepción de competencia. El 18 % de los encuestados en la encuesta de gastos de bolsillo no tenía medicamentos disponibles y el 55 % no podía pagarlos. Los coeficientes de Gini fueron 0.40 (2014) y 0.76 (2017). El aumento de los precios, la relativa independencia de los minoristas para establecer los precios y el bajo acceso al seguro social/privado aumentan los gastos de bolsillo.

The SNORD116 locus lies in the 15q11-13 region of paternally expressed genes implicated in Prader-Willi Syndrome (PWS), a complex disease accompanied by obesity and severe neurobehavioural disturbances. Cases of PWS patients with a deletion encompassing the SNORD116 gene cluster, but preserving the expression of flanking genes, have been described. We report a 23-year-old woman who presented clinical criteria of PWS, including the behavioural and nutritional features, obesity, developmental delay and endocrine dysfunctions with hyperghrelinemia. We found a paternally transmitted highly restricted deletion of the SNORD116 gene cluster, the shortest described to date (118 kb). This deletion was also present in the father. This finding in a human case strongly supports the current hypothesis that lack of the paternal SNORD116 gene cluster has a determinant role in the pathogenesis of PWS. Moreover, targeted analysis of the SNORD116 gene cluster, complementary to SNRPN methylation analysis, should be carried out in subjects with a phenotype suggestive of PWS.

Magnet/superconductor hybrids (MSHs) hold the promise to host emergent topological superconducting phases. Both one-dimensional (1D) and two-dimensional (2D) magnetic systems in proximity to s -wave superconductors have shown evidence of gapped topological superconductivity with zero-energy end states and chiral edge modes. Recently, it was proposed that the bulk transition-metal dichalcogenide 4Hb-TaS 2 is a gapless topological nodal-point superconductor (TNPSC). However, there has been no experimental realization of a TNPSC in a MSH system yet. Here we present the discovery of TNPSC in antiferromagnetic (AFM) monolayers on top of an s -wave superconductor. Our calculations show that the topological phase is driven by the AFM order, resulting in the emergence of a gapless time-reversal invariant topological superconducting state. Using low-temperature scanning tunneling microscopy we observe a low-energy edge mode, which separates the topological phase from the trivial one, at the boundaries of antiferromagnetic islands. As predicted by the calculations, we find that the relative spectral weight of the edge mode depends on the edge’s atomic configuration. Our results establish the combination of antiferromagnetism and superconductivity as a novel route to design 2D topological quantum phases. Magnet/superconductor hybrids have been explored for the realization of topological superconductivity but have mainly focused on ferromagnets with full gaps. Here, the authors find that the antiferromagnet/superconductor heterostructure of monolayer Mn on a Nb(110) surface is a topological nodal-point superconductor.

Elranatamab is a humanized B-cell maturation antigen (BCMA)-CD3 bispecific antibody. In the ongoing phase 2 MagnetisMM-3 trial, patients with relapsed or refractory multiple myeloma received subcutaneous elranatamab once weekly after two step-up priming doses. After six cycles, persistent responders switched to biweekly dosing. Results from cohort A, which enrolled patients without prior BCMA-directed therapy ( n  = 123) are reported. The primary endpoint of confirmed objective response rate (ORR) by blinded independent central review was met with an ORR of 61.0% (75/123); 35.0% ≥complete response. Fifty responders switched to biweekly dosing, and 40 (80.0%) improved or maintained their response for ≥6 months. With a median follow-up of 14.7 months, median duration of response, progression-free survival and overall survival (secondary endpoints) have not been reached. Fifteen-month rates were 71.5%, 50.9% and 56.7%, respectively. Common adverse events (any grade; grade 3–4) included infections (69.9%, 39.8%), cytokine release syndrome (57.7%, 0%), anemia (48.8%, 37.4%), and neutropenia (48.8%, 48.8%). With biweekly dosing, grade 3–4 adverse events decreased from 58.6% to 46.6%. Elranatamab induced deep and durable responses with a manageable safety profile. Switching to biweekly dosing may improve long-term safety without compromising efficacy. ClinicalTrials.gov identifier: NCT04649359 . In a pivotal phase 2 trial, elranatamab, a bispecific antibody targeting B-cell maturation antigen (BCMA) and CD3, had a confirmed objective response rate of 61% in patients with relapsed or refractory multiple myeloma who had not previously received BCMA-directed therapy.

We present an extension of the expert mode of the MadAnalysis  5 program dedicated to the design or reinterpretation of high-energy physics collider analyses. We detail the predefined classes, functions and methods available to the user and emphasize the most recent developments. The latter include the possible definition of multiple sub-analyses and a novel user-friendly treatment for the selection criteria. We illustrate this approach by two concrete examples: a CMS search for supersymmetric partners of the top quark and a phenomenological analysis targeting hadronically decaying monotop systems.

The addition of ribociclib, a cyclin-dependent kinase inhibitor, to the aromatase inhibitor letrozole in women with metastatic hormone receptor–positive, HER2-negative breast cancer improved median overall survival by more than a year as compared with letrozole alone (63.9 months vs. 51.4 months). No new toxic effects were recognized.

Among patients at intermediate risk for aortic-valve surgery, transcatheter aortic-valve replacement (TAVR) was noninferior to standard surgery, although each procedure had a different pattern of adverse events. Transcatheter aortic-valve replacement (TAVR) with the use of a self-expanding prosthesis is superior to medical therapy in patients with severe, symptomatic aortic stenosis in whom surgical aortic-valve replacement has been associated with prohibitive risk. 1 Among patients who are at high risk for standard surgery, TAVR may be the preferred option. 2 – 4 The adoption of TAVR in patients with aortic stenosis at high risk for surgery has been rapid, as shown by enrollment in the ongoing Society of Thoracic Surgeons–American College of Cardiology Transcatheter Valve Therapy Registry. 5 The comparative efficacy of TAVR and surgery has been less well studied among patients . . .