Rat Mme (Neprilysin) ELISA Kit

A devastating mass mortality event (MME) very likely caused by the protozoan Haplosporidium pinnae first detected in 2016 in the Western Mediterranean Sea, is pushing the endemic bivalve Pinna nobilis to near extinction. Populations recovery, if possible, will rely on larval dispersal from unaffected sites and potential recolonization through recruitment of resistant juveniles. To assess the impact of the MME on the species' larval recruitment, an unprecedented network of larval collector stations was implemented over several thousands of kilometers along the Western Mediterranean coasts during the 3 years after the onset of the MME. The findings of this network showed a generalized disruption in recruitment with dramatic consequences for the recovery of the species. However, there were exceptions to this pattern and recruits were recorded in a few sites where the resident population had been decimated. This hints to the importance of unaffected populations as larval exporting sources and the role of oceanographic currents in larval transport in the area, representing a beacon of hope in the current extremely worrying scenario for this emblematic species.

Purpose: High-strength opioid formulations were delisted (removed) from Ontario's public drug formulary in January 2017, except for palliative patients. We evaluated the impact of this policy on opioid utilization and dosing. Methods: We conducted a longitudinal study among patients receiving publicly funded, high-strength opioids from August 2016 to July 2017. The primary outcome measure was weekly median daily opioid dose (in milligrams of morphine or equivalent; MME) of (1) publicly funded and (2) all opioid prescriptions irrespective of funding source, evaluated using interrupted time series analyses and stratified by palliative care status. Results: Following policy implementation, the weekly median daily dose of publicly funded opioids decreased immediately among non-palliative patients by 10 MME (95% confidence limit [CL], -16.8 to -3.1) from a pre-intervention dose of 424.5 MME (95% CL, 417.8-431.2) and fell gradually among palliative patients by 3.9 MME per week (95% CL, -5.5 to -2.3) from a pre-intervention dose of 450.1 MME (95% CL, 432.5-467.7). In contrast, among all opioid prescriptions, gradual reductions in weekly median daily doses were observed only for non-palliative patients, which decreased by 0.7 MME per week (95% CL, -1.3 to -0.2) from a pre-intervention dose of 426.2 MME (95% CL, 420.9-431.5). Conclusion: The delisting of publicly-funded, high-strength opioids was accompanied by changes in funding source and small reductions in the weekly median daily doses dispensed. Although observed dose reductions of less than 1 MME weekly are likely not clinically relevant, safety implications of these changes require further monitoring.