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Soda taxes aim to reduce excessive sugar consumption. We assess who is most impacted by soda taxes. We estimate demand using micro longitudinal data covering on-the-go purchases, and exploit the panel dimension to estimate individual-specific preferences. We relate these preferences and counterfactual predictions to individual characteristics and show that soda taxes are relatively effective at targeting the sugar intake of the young, are less successful at targeting the intake of those with high total dietary sugar, and are unlikely to be strongly regressive especially if consumers benefit from averted internalities.

There are growing calls to restrict advertising of junk foods. Whether such a move will improve diet quality will depend on how advertising shifts consumer demands and how firms respond. We study an important and typical junk food market—the potato chips market. We exploit consumer level exposure to adverts to estimate demand, allowing advertising to potentially shift the weight consumers place on product healthiness, tilt demand curves, have dynamic effects and spillover effects across brands. We simulate the impact of a ban and show that the potential health benefits are partially offset by firms lowering prices and by consumer switching to other junk foods.

Restrictions on the advertising of less-healthy foods and beverages is seen as one measure to tackle childhood obesity and is under active consideration by the UK government. Whilst evidence increasingly links this advertising to excess calorie intake, understanding of the potential impact of advertising restrictions on population health is limited. We used a proportional multi-state life table model to estimate the health impact of prohibiting the advertising of food and beverages high in fat, sugar, and salt (HFSS) from 05.30 hours to 21.00 hours (5:30 AM to 9:00 PM) on television in the UK. We used the following data to parameterise the model: children's exposure to HFSS advertising from AC Nielsen and Broadcasters' Audience Research Board (2015); effect of less-healthy food advertising on acute caloric intake in children from a published meta-analysis; population numbers and all-cause mortality rates from the Human Mortality Database for the UK (2015); body mass index distribution from the Health Survey for England (2016); disability weights for estimating disability-adjusted life years (DALYs) from the Global Burden of Disease Study; and healthcare costs from NHS England programme budgeting data. The main outcome measures were change in the percentage of the children (aged 5-17 years) with obesity defined using the International Obesity Task Force cut-points, and change in health status (DALYs). Monte Carlo analyses was used to estimate 95% uncertainty intervals (UIs). We estimate that if all HFSS advertising between 05.30 hours and 21.00 hours was withdrawn, UK children (n = 13,729,000), would see on average 1.5 fewer HFSS adverts per day and decrease caloric intake by 9.1 kcal (95% UI 0.5-17.7 kcal), which would reduce the number of children (aged 5-17 years) with obesity by 4.6% (95% UI 1.4%-9.5%) and with overweight (including obesity) by 3.6% (95% UI 1.1%-7.4%) This is equivalent to 40,000 (95% UI 12,000-81,000) fewer UK children with obesity, and 120,000 (95% UI 34,000-240,000) fewer with overweight. For children alive in 2015 (n = 13,729,000), this would avert 240,000 (95% UI 65,000-530,000) DALYs across their lifetime (i.e., followed from 2015 through to death), and result in a health-related net monetary benefit of £7.4 billion (95% UI £2.0 billion-£16 billion) to society. Under a scenario where all HFSS advertising is displaced to after 21.00 hours, rather than withdrawn, we estimate that the benefits would be reduced by around two-thirds. This is a modelling study and subject to uncertainty; we cannot fully and accurately account for all of the factors that would affect the impact of this policy if implemented. Whilst randomised trials show that children exposed to less-healthy food advertising consume more calories, there is uncertainty about the nature of the dose-response relationship between HFSS advertising and calorie intake. Our results show that HFSS television advertising restrictions between 05.30 hours and 21.00 hours in the UK could make a meaningful contribution to reducing childhood obesity. We estimate that the impact on childhood obesity of this policy may be reduced by around two-thirds if adverts are displaced to after 21.00 hours rather than being withdrawn.

IPX066 is an oral, extended-release, capsule formulation of carbidopa-levodopa. We aimed to assess this extended-release formulation versus immediate-release carbidopa-levodopa in patients with Parkinson's disease and motor fluctuations. We did a phase 3, randomised, double-blind, double-dummy study at 68 academic and clinical centres in North America and Europe. Patients with Parkinson's disease who had at least 2·5 h per day of off-time underwent 3 weeks of open-label immediate-release carbidopa-levodopa dose adjustment followed by 6 weeks of open-label extended-release carbidopa-levodopa dose conversion. These patients were then randomly allocated (1:1), by use of an interactive web-response system, to 13 weeks of double-blind treatment with extended-release or immediate-release carbidopa-levodopa plus matched placebos. The primary efficacy measure was off-time as a percentage of waking hours in all patients randomly allocated to treatment groups, adjusted for baseline value. This study is registered with ClinicalTrials.gov, number NCT00974974. Between Sept 29, 2009, and Aug 16, 2010, we enrolled 471 participants, of whom 393 (83%) were randomly allocated in the double-blind maintenance period and were included in the main efficacy analyses. As a percentage of waking hours, 201 patients treated double-blind with extended-release carbidopa-levodopa (mean 3·6 doses per day [SD 0·7]) had greater reductions in off-time than did 192 patients treated double-blind with immediate-release carbidopa-levodopa (mean 5·0 doses per day [1·2]). Covariate-adjusted end-of-study means were 23·82% (SD 14·91) for extended-release carbidopa-levodopa and 29·79% (15·81) for immediate-release carbidopa-levodopa (mean difference −5·97, 95% CI −9·05 to −2·89; p<0·0001). Extended-release carbidopa-levodopa reduced daily off-time by, on average, an extra −1·17 h (95% CI −1·69 to −0·66; p<0·0001) compared with immediate-release carbidopa-levodopa. During dose conversion with extended-release carbidopa-levodopa, 23 (5%) of 450 patients withdrew because of adverse events and 13 (3%) withdrew because of a lack of efficacy. In the maintenance period, the most common adverse events were insomnia (seven [3%] of 201 patients allocated extended-release carbidopa-levodopa vs two [1%] of 192 patients allocated immediate-release carbidopa-levodopa), nausea (six [3%] vs three [2%]), and falls (six [3%] vs four [2%]). Extended-release carbidopa-levodopa might be a useful treatment for patients with Parkinson's disease who have motor fluctuations, with potential benefits including decreased off-time and reduced levodopa dosing frequency. Impax Laboratories.

Random utility models are widely used to study consumer choice. The vast majority of applications assume utility is linear in consumption of the outside good, which imposes that total expenditure on the subset of goods of interest does not affect demand for inside goods and restricts demand curvature and pass-through. We show that relaxing these restrictions can be important, particularly if one is interested in the distributional effects of a policy change, even in a market for a small budget share product category. We consider the use of tax policy to lower fat consumption and show that a specific (per unit) tax results in larger reductions than an ad valorem tax, but at a greater cost to consumers.

Abstract A 75-year-old male presented with right eye pain and proptosis. His history was significant for renal cell carcinoma treated with left nephrectomy 2 years previously. Computed tomography (CT) imaging demonstrated a 1.6-cm enhancing lesion in the right retrobulbar space. Surgical biopsy revealed a low-grade metastatic carcinoid tumor. At retrospective review, the primary renal lesion from 2 years prior was rediagnosed as consistent with a renal carcinoid tumor. Indium-111 octreotide single photon emission CT/CT imaging demonstrated a solitary metastasis within the right extraocular muscles. The patient subsequently developed additional metastases within the remaining right kidney and lung.

Fishery-independent data on fishes and crustaceans collected in spring and fall over three decades (1986–2015) from coastal areas of southeastern Louisiana, Mississippi, and Alabama were analyzed to determine if these areas differed in species composition and environmental conditions over this period. Multivariate community analyses revealed significant differences in species composition among the three areas in trawl collections for both spring (ANOSIM, R = 0.543, p < 0.001) and fall (R = 0.722, p < 0.001), while seine collections were not significantly different among the areas for either season (spring, R <-0.06, p = 0.61; fall, R < 0.167, p = 0.14). The most important factor contributing to these differences was the presence of more shell substrate at the Louisiana sites (LINKTREE analysis, B% = 86, p < 0.05). Abundance data for common species were used to test for changes over the three decades. Blue crabs (Callinectes sapidus) and least puffers (Sphoeroides parvus) experienced decreases in four of eight area–season–gear scenarios. Four species of flatfishes also experienced multiple declines. Salinity increased at the Louisiana trawl sites over the period in both spring (+ 2.92; ANOVA, p < 0.001) and fall (+ 5.97; ANOVA, p = 0.001–0.002), while spring trawl sites became warmer in Mississippi (+ 2.15°C; ANOVA, p = 0.001–0.002). Alabama trawl sites became warmer in both spring (+ 3.36°C; ANOVA, p < 0.001) and fall (+ 1.91°C; ANOVA, p < 0.001). With declines in species and changes in environmental conditions, this region faces multiple challenges in maintaining its estuarine fisheries.

Genetic diversity, population genetic structure and isolation by distance (IBD) were assessed in a viviparous coastal shark (the lemon shark Negaprion brevirostris) across 8 western Atlantic samples spaced between ~150 and 7000 km apart. Juveniles (N = 325) were sequenced at 2 mitochondrial loci (1729 bp) and typed at 9 nuclear encoded microsatellite loci. Analysis of mitochondrial sequences revealed higher diversity at low-latitude island samples compared to high-latitude continental samples, consistent with an equatorial center-of-origin for this species. There were 5 distinct groups across our sampling areas (Brazil, Louisiana, Cape Canaveral, Gullivan Bay and the Florida Keys/Bahamas/Virgin Islands; pairwise ΦST = 0.07–0.87) and all but one pair of the 8 samples also exhibited significantly different haplotype frequencies (pairwise F ST = 0.10–0.51). Bayesian analysis indicated that the Brazil and Louisiana samples were generally isolated from the others, but most of the rest were diverged although still connected or recently connected by migration. In contrast, structure was only detected between the most distant sample (Brazil) and all of the others using the microsatellite markers (pairwise F ST = 0.03–0.06). There was a significant pattern of IBD for all markers and measures of genetic differentiation (r² = 0.65–0.81, p < 0.05–0.01), but not after removing the Brazil sample. There was evidence that glacial and post-glacial historical processes and sex-specific differences in philopatry affected IBD. Because of the relatively fine-scale population structure of this and other large coastal shark species more attention should be paid to local processes in the conservation and fisheries management of these species.

To assess possible impacts on Lake Pontchartrain fishes from the 2005 hurricanes, we compared trawl, beach seine, and gillnet collections taken before (2000–2003, 2005) and after (2006–2009) to determine if significant assemblage changes occurred. We also compared basic environmental variables to test for hurricane-related changes. Significant post-hurricane changes in fish assemblages occurred in trawl (analysis of similarity (ANOSIM), R < 0.090, p < 0.05) and beach seine (ANOSIM, R < 0.120, p < 0.05) collections across all seasons. Gillnet assemblages exhibited changes in only one season (ANOSIM, R = 0.045, p < 0.05). These consistently low global R values (all R < 0.120) across all gears suggest only minor compositional changes in species. When peak abundance periods were compared for individual species, Gulf menhaden (Brevoortia patronus) declined in trawl collections after the hurricanes (Friedman's test, χ ² = 6.00, p = 0.014) but increased in gillnet collections (Friedman's test, χ ² = 5.00, p = 0.025). Hardhead catfish (Ariopsis felis) increased in trawl collections, but Gulf pipefish (Syngnathus scovelli), naked gobies (Gobiosoma bosc), and rough silverside (Membras martinica) all declined in beach seine samples and Atlantic croakers (Micropogonias undulatus), Spanish mackerel (Scomberomorus maculatus), and sand seatrout (Cynoscion arenarius) all declined in gillnet samples. In general, salinity increased and water clarity and dissolved oxygen decreased after the hurricanes. While the overall composition of Lake Pontchartrain fish assemblages remains stable, the significant decline of some species and changes in certain environmental variables are cause for concern. Future monitoring should determine if all elements of this estuary will recover from these impacts.