Статті в журналах з теми "3506 Marketing"

Plantain marketing offers great profit-making, yet it is unclear if these have translated to more profits, making it imperative to examine the drivers of plantain marketing. Primary data collected with structured questionnaire in purposive 2-staged random sampling were analyzed using net marketing income, marketing margin, marketing efficiency and multiple linear regression models. Plantain marketing was mainly done by married educated women, averaged 40 years of age, belonging to households averaging 6 persons. Net monthly profit of $63.51 (₦26,050.38), average marketing margin of 30.84% and marketing efficiency of 35.06% were returned. Suggesting plantain marketing is profitable and viable but largely inefficient. Cost of plantain and marketing experience were positively significant (p≤0.05). Plantain marketing faced constraints like seasonality of plantain, inadequate finance, price fluctuations, high transportation costs, bulkiness, spoilage/breakage and high plantain costs. Plantain marketers should form/join cooperatives to obtain low-interest loans, mitigate marketing costs and enjoy economies of scale.

The aims of this study is to apply the Auto Sales Forecasting software to predict sales transaction data. The Auto Sales Forecasting software consists of two main features namely descriptive analysis and forcasting features along with its visualization. Forecasting methods contained in the Auto Sales Forecasting application are forecasting methods of Simple Moving Average, Robust Exponantial Smoothing, Auto ARIMA, Artificial Neural Network, Holt-Winters, and Hybrid Forecast. The Auto Sales Forecasting software can intelligently choose the best forecasting method based on RMSE values. The results showed that the Auto Sales Forecasting software successfully analyzed the sales transaction data. From the analysis it was found that there were 43 types of products produced and sold by the Futry Bakery & Cake Store. Three of them are the types of products that are most in demand by consumers, namely Sweet Bread, Maros Bread, and Traditional Cakes 3500. The best selling product type, Sweet Bread, is used to build forecasting models. The best forecasting method is the Robust Exponential Smoothing method with the smallest RMSE value of 0.83 on the variable number of sold out products. Forecasting results using the Robust Exponantial Smoothing method show that the average number of products to sell for the next seven days ranges from 116 products with a certain confidence interval value.

This research was made to understandand analyze how big is the influence of marketing mix service toward customer loyalty using tourist service Taman Air Panas Drajat Pass. A method used in this research about the influence of marketing mix service toward customer loyalty arefield observation method, interview, questionnaire, and literature study using liker scale. In samle determination, the writer usedaccidental sampling method for about 90 samles whereas the approximation method used in data analysis methodis Linearregression method which has the function to know the relationship between independent variable, that is marketing mix (X) with dependent variable, that is customer loyalty (Y). The research showed us that marketing mix consist of: product (X1), price (X2), place (X3), promotion (X4), physical evidance (X5), people (X6),and (x7) simultaneously has a significant. Effect toward customer loyalty (Y). But partially, the one who has a significant effect toward customer loyalty is variableprocess with the significantlevel that is 0,017. This marketing mix can expalin that customer loyalty of Taman Air Panas Darajat Pass is 0,356 or 35,6% while the rest of it, that is 64,4% is the customer loyalty that has not been explained by customer’s attitude, purchasing conviction variable, evaluation variable normative conviction variable and motivation variable.

This study aimed to determine the marketing distribution channel to analyze the absorption of paprika from the farmer in Baturiti district to the last costumers to calculate the marketing margins obtained in each distribution channel. This research was conducted in July-August 2018. This study used purposive sampling survey. There are five distribution channels of paprika from the farmer in Baturiti regency to the last costumers namely: 1st line (Farmer ? Traditional Market Trader ? costumers), 2nd line (Farmer ? Local Collector ? City Collector? Consumer), 3rd line (Farmer ? Local Collector ? City Collector? Costumer), 4th line (Farmer ? City Collector? Consumer), 5th line (Farmer ? City Collector? Consumer). The distribution shows that the rate market of paprika and farmer produce 2.655 monthly. Absorption of paprika rate that is distributed by farmer to local collector, city collector, and traditional market are 25,6 percent, 38,8 percent, 35,6 percent. Paprika that is distributed by local collector to city collector and traditional market are 19,6 percent them 6 percent. City collector obtain 58,4 percent paprika from farmer and local collector then later distribute 29,8 percent, 21,5 percent, 7,1 percent the paprika to each hotel or restaurant, supermarket, and traditional market. City collect obtain 58,4 percent paprika for faram and local collect then later distribution the to hotel or restaurant, supermarket and traditional market by the percentage of 29,8 percent, 21,5 percent, 7,1 percent respectively. Based on the five lanes determined in this study, lane III is the longest distribution, but the lane has the highest marketing margin and profit margin, lane III and V. Line I is the shortest distribution path of the five lanes, and has a marketing margin and lowest profit because the marketing costs incurred are small and the selling price at the final consumer level is also the lowest among the other five lines.

The present study was conducted to know the fish drying activities, species used in fish drying and marketing channel of dried fish in Kuakata coast of Patuakhali district of Bangladesh. Sea fishes are mostly used for drying and dry fish producers collected raw fishes from arat (landing centers) (70%), fishermen (25%) and little amount from own capture (5%). It was found that 21 fish species were used for drying among them 3 species (Harpadon nehereus, Setipinna phasa, Lepturacanthus savala) were commonly used and other 18 species were fairly used. The peak fish drying season was observed at mid-October to mid-February (in Bengali Kartik to Magh). It was observed that the dry fish producers used salt to produce good quality dry fish and salt mixing rate is 2 kg salt for 30-35 kg raw fish. The duration of drying at normal weather condition is varied between 3-5 days depending on the size of fishes. After drying, the dried fishes were packed in either jute bags or polythene bags and stored at room temperature for marketing. About 95% dried fish products are sold in the wholesale market at Chittagong, Syedpur, and Dhaka and rest 5% sold to the local retail market. However, three (3) step dried fish marketing channels were observed in the study area. The producers sold their product at very lower price and it ranged between Tk. 120-3200 per Kg. The retail price of the dried fishes ranged from Tk. 200-3500 per Kg. The dry fish producers and intermediaries faced various problems like inadequate capital, natural calamities, lack of scientific knowledge and technology, price instability, lack of transport facilities, inadequate storage facilities, lack of physical marketing facilities and marketing information. Asian Australas. J. Biosci. Biotechnol. 2020, 5 (2), 48-59

This study was an attempt to calculate and compare the profitability of onions harvested as green and dry (mature) in Botswana. Half of the planted onions were harvested and sold as green and half were harvested and sold as dry onions. The cost of production of green onions was 32.78% higher than the cost of production of dry onions. The irrigation and marketing expenses contributed the highest difference in the cost of production of green and dry onions. The major cost item contributing to the cost of green onions production was marketing cost (32.86%) followed by irrigation cost (23.77%) and harvesting cost (18.53%) whereas the highest cost of production for dry onions was contributed by irrigation (38.58%) followed by marketing (19.45%) and planting (11.96%). The marketing cost for green onions was almost double (35.6%) as compare to the dry onions (18.2%). The total return from green onions was 50.90% higher than the returns from dry onions. Gross margin of onions harvested as green was 63% higher than the gross margin from dry onions, which indicated that the production of green onions is more profitable as compare to production of dry onions. The farmers preferred onion harvested as green because it generates regular and higher returns than onions harvested as mature. Government should support farmers through some policies such as Minimum Support Price (MSP) for dry onions, distribution of Mini Ferti–Seed Kit (Seeds of improved varieties and fertilizer package), construction of storages and formation of cooperatives. Int. J. Agril. Res. Innov. & Tech. 3 (1): 73-77, June, 2013 DOI: http://dx.doi.org/10.3329/ijarit.v3i1.16096

Vegetables can be in the form of plants or parts of plants that are consumed fresh or ripe as part of the diet. There are very diverse types of vegetables in the form of tubers, fruit, flowers or leaves. Leaf vegetables are the type most consumed. 97.29% of the Indonesian population consumes vegetables, the types of vegetables consumed by the Indonesian population are leaf vegetables such as kale, chicory and caisim. The purpose of this research is to analyze the efficiency of trading channels and marketing functions carried out by each marketing actor in the Bogor City Traditional Market by using trading margin, farmer share, profit ratio and R / C cost. This research was conducted on the trading channel actors in the Traditional Market in Bogor City. The number of respondents in the study were 15 farmer respondents and 42 merchant respondents from both markets. The data analysis used purposive method for lapak traders and snowball sampling from retailers to farmers. The results of this study were four leaf vegetable trading channels in the Traditional Market of Bogor City with the efficiency level of the three vegetables considered to be the most efficient, namely channel IV on kale vegetables, channel II on chicory and channel IV on caisim, with each having a margin of yield of 3500, 800, 700 and the highest farmer's share was 82.93%, 81.40% and 59.52%. Thus it is necessary to do more analysis related to the strategy of developing vegetable commodities of kale, chicory and caisim in traditional markets related to marketing activities.

the article presents the results of the study of the marketing market of medicines for the treatment of breast cancer in Ukraine during 2019-2020. Medicine treatment schemes based on a clinical protocol were analyzed. On December 1, 2019, 184 drugs were registered for the treatment of breast cancer in Ukraine, and on December 1, 2020 - 194. In 2020, the largest share among of the studied drugs belongs to the group of antineoplastic and immunomodulatory drugs - 82.0 %, and the group of drugs that affect the musculoskeletal system - 18.0 %. On December 1, 2020, drugs were represented by 43 manufacturers, of which 18.6 % were Ukrainian and 81.4 % were foreign. Among Ukrainian companies, the primacy belongs to Pharmex Group LLC (4.1 %), Teva Ukraine LLC (3.1 %) and Farmak JSC (2.6 %). The largest share of foreign suppliers occupies Great Britain - 26.3 %, Switzerland and India by 11.9 %. At that time, in 5 pharmacotherapeutic groups (L01AA01, L01BA01, L01CA04, L01XC07, M05BA03) is not represented by any drug Ukrainian manufacturer. Analysis of the assortment of drugs for the treatment of breast cancer by dosage form in 2020 showed that the main share (35.6 %) is represented by concentrate for solution for infusion, 21.6 % - tablets and 20.6 % - lyophilisate for solution for infusion. Other dosage forms form a total of 22.2 % of the total assortment of drugs, studied in the Ukrainian market.

Purpose The purpose of this paper is to examine how and when a reputation for corporate social responsibility (CSR) can deter dysfunctional consumer behaviors (DCBs) such as shoplifting or negative word-of-mouth (WOM) in response to firm failures. The authors predict that congruency of the CSR activities and the basis for the firm failure (e.g. environmental protection, environmental harm) provides protection for firms while incongruency (e.g. environmental protection, social harm) does not. The authors base this prediction on the process of retroactive attribution and sense-making. Design/methodology/approach Across two studies the research finds support that a reputation for CSR can deter consumer dysfunctional behavior. Study 1 uses an experimental design with a Mturk sample, and a behavioral outcome using an overpayment situation, to examine when consumers will act honestly and recognize overpayment. Study 2 uses secondary data, across three novel data sources (Google trends data, an existing data set of consumer perceptions of CSR and Factiva to uncover press coverage of negative firm events). Study 2 examines how CSR reputation impacts consumers’ participation in negative WOM in response to firm failures. Findings Study 1 finds support for CSR congruency as a protection mechanism against dysfunctional behavior in response to negative events. The authors find that dysfunctional behaviors in conditions of congruency, while incongruent and a control condition do not provide such protections. Study 2 supports these findings using Google trends data in the form of online negative WOM. The authors find that when firms are known for their social performance, negative events in the social domain result in significantly lower levels of negative WOM. Originality/value The current paper makes the novel prediction that consumers will use a current negative event (corporate social irresponsibility) to re-evaluate previous CSR. Thus, in contrast with prior research, the authors argue that a negative event is not affected by previous CSR but that previous CSR is affected by a negative event. Furthermore, the authors posit that the congruency between the transgression and previous CSR moderates consumer perceptions, such that incongruent CSR and transgression contexts lead to increased DCBs through consumers’ retroactive sense-making process.

Background: Recent years have seen a transition in consumer’s buying behaviour for foods having better nutrition, transparent claims with more clean processes and ingredients. Objective: This paper aims at understanding the factors that influence consumers’ food buying behaviour, perceptions and healthy food choices. Methodology: Quantitative research was done in restricted cities of India through online media. Information was collected (targeting21-40 years age group) from 470 respondents (64.4% males and 35.6% females). Responses were recorded through an online circulated questionnaire containing 15 close-ended questions, which were statistically analyzed through MS-excel using graphical representations. Results: A greater inclination was seen towards healthier options in staples such as multigrain flour. The survey findings reported that around 34.5% of consumers are taking the product quality claims and source of ingredients seriously, and also consumers do care about the environmental impact of the products, with 83.62% respondents preferring products which are environment friendly and socially responsible. Conclusion: It can be concluded that there has been a considerable shift towards healthier food choices. Companies should focus on strategies to promote healthier choices, clean labels, more transparency and reduce their environment and social burden. Marketing strategies may also be geared towards promotion of products through online platforms since millennia’s, who compromise 48% of work force spend their major time online.

Objetivo.Determinar la asociación entre el caries dental y estado nutricional en el Perú en el año 2014.Materiales y métodos.La presente investigación tuvo un diseño ecológico, la cual se desarrolló en base a datos de caries dental de los años 2012-2014del Ministerio de Salud del Perú y de los registros de la Encuesta Demográfica y de Salud Familiar del 2014. Se consideraroncomo variables del estudio el estado nutricional y caries dental. Para el análisis estadístico se emplearon las pruebas deANOVA y Correlación de Pearson), se contó con un nivel de confianza de 95 % y un p<0,05.Resultados.En el Perú, sereportó un 85,6 % de prevalencia de caries dental y un CPOD de 3,45; 14,6 % de desnutrición crónica, 35,6 % de anemia enniños menores de 5 años y 46,8 % en menores de 3 años. Se encontró asociación y correlación entre caries dental y estadonutricional (p<0,05). Conclusión. Existe asociación entre caries dental y estado nutricional en el Perú en el año 2014.

Constantius II aimed to create a multi ruler system, since he had made the Roman Empire into a one man ruling state directly after the death of Constans(337-350 as Augustus). He intended to set up a system in which Augustus should be the first representative ruler with a loyal Caesar as the subordinated ruler. This idea was forced on both Caesars, Gallus(351-354 as Caesar) and Julianus(355-361 as Caesar). The traditional studies on this topic have tended to be understood and grasped mostly from the viewpoint of Julianus, because of the biased description of the sources and their structural restriction in the preservation. The studies on the period under the governorship of Julianus in Gaul have also been made in such biased way, written from a point of view in which Julianus is the main actor, and this pattern has still not changed thereafter. In this study the author will try to illuminate the relationship between both persons from the point of view of the Augustus Constantius, especially on his policy towards Julianus. It is time to review the political context of that era from Constantius' perspective, a viewpoint that has long been ignored. If we can make use of a handful of sources about our theme and conceive some hypothesis, this will provide an advanced scholarly discussion on the attitudes with which Constantius might have treated Julianus. The main objectives of the study would involve reconsidering how the relations between Constantius and Julianus came about and to what degree Constantius planned against his rival Julianus. Consequently we will be able to interpret the whole development of that relationship. Thus I will establish three stages for that relationship on the basis of the process of the incidents, reconsidering their meaning. Here attention must be paid especially to the change of Constantius’ attitude who had experienced the first and second stage in the relation. It was a political calculation on the part of Constantius, considering that he ought to avoid a crisis during the war against the Persians and also had to overwhelm or remove his rival Julianus, who had become too influential in Gaul.(Korea University)

Business Development Service Providers Organization (BDSPO) play vital role specially in Micro Entrepreneurship Development (MED) sectors. BDSPO provides various types of services such as skill oriented training, facilitates to establish enterprises, identify sources of raw materials and other equipments, establish market link etc. Major Activities of the BDSPOs includes social mobilization of potential micro entrepreneurs, formation of Micro Enterprise Group (MEG) formation, House-Hold (HH) survey and participants selection, conduct Entrepreneurship Development Training (EDT) programmes, provides skill training and appropriate technology support, help to establish marketing linkage and product promotion, need assessment of entrepreneurs, identify and provide scale up activities, facilitates micro credit accessibilities, facilitates to formation of cooperatives and product association, facilitation of construction of new Common Facility Centers (CFCs) and examine as well as assess the uses of existing technology. The main objective of MEDEP is “improve the socio economic status hardcore poor and non hard core poor people through Micro Enterprise”. On the response of the question of how do entrepreneur rate the business supportive policies of the other agencies like BDSPOs, 32.5percent entrepreneurs felt that the business supportive policies of the other agencies supportive. By 35.6 percent respondents felt the supportive policies of the other agencies is less supportive. The researches try to examine of the change in self-confidence before participation in EDP and after EDP. Paired t-test between effectiveness before participation in EDP and after EDP has been conducted. This shows a statistically significant influence of EDP on confidence level. Janapriya Journal of Interdisciplinary Studies, Vol. 5 (December 2016), page: 14-26

Delays in initiating the cooling of freshly harvested `Chandler' strawberries (Fragaria ×ananassa) were compared with prompt cooling to determine how such handling affected development of postharvest decays during subsequent storage and marketing. Strawberries at the three-quarter to full red ripeness stages were harvested four times between mid-June and late July, inoculated with Botrytis cinerea or Rhizopus stolonifer and then handled to simulate prompt or delayed precooling prior to storage. This was done by incubating fruit at 35 °C (95.0 °F) and 70% to 80% relative humidity (RH) for 1 or 6 hours. The fruit were then forced-air cooled to 5 °C (41.0 °F) in 1 hour and stored for 7 days at 2 °C (35.6 °F) and 85% to 95% RH, plus displayed in a simulated market at 20 °C (68.0 °F) and 85% RH for 1 day. Decay incidence increased as the season progressed. For non-inoculated fruit, prompt cooling reduced the incidence of decay by an average of 25% and the decay severity by ∼24%. With inoculated fruit, prompt cooling resulted in 15% and 29% decreases in the incidence and severity, respectively, of rhizopus rot compared to delayed cooling, and 5% and 22% decreases in the incidence and severity, respectively, of botrytis rot. Overall, the incidence of botrytis and rhizopus fruit rot averaged 60% and 85% in the prompt and delayed cooling treatments, respectively. Although prompt cooling is important for minimizing postharvest decay of strawberries, temperature management alone may not sufficiently control postharvest decay when decay pressure is high.

O objetivo deste estudo foi analisar a ocorrência dos casos notificados de doença diarreica aguda (DDA) da população do oeste de Santa Catarina, observando a faixa etária, sazonalidade, planos de tratamento e a distribuição geográfica. Foram analisados os registros de 37 municípios referentes ao período de 2007 a 2011. Foram identificados 77.986 casos, com média anual de 3,86% da população, sendo 22% ocorridos em crianças entre um e quatro anos de idade e de 57,3% nos maiores de dez anos. A distribuição geográfica dos casos, nos municípios, foi de 3% a 35% da população. Os planos de tratamento mais utilizados foram o plano A (50,8%) e o C (35,6%). A ocorrência das DDA teve sazonalidade entre outubro a março e mostrou correlação entre frequência de casos e a temperatura média. Houve queda da mortalidade, provavelmente, isso se deve aos avanços das políticas públicas e dos tratamentos utilizados em pacientes, especialmente a terapia com sais de reidratação oral, com alta eficácia.

ABSTRACT Background Excessive sugar intake is now recognized as a key risk factor for obesity, type 2 diabetes, and cardiovascular diseases. In contrast, evidence on the sugar–cancer link is less consistent. Experimental data suggest that sugars could play a role in cancer etiology through obesity but also through inflammatory and oxidative mechanisms and insulin resistance, even in the absence of weight gain. Objective The objective was to study the associations between total and added sugar intake and cancer risk (overall, breast, and prostate), taking into account sugar types and sources. Methods In total, 101,279 participants aged &gt;18 y (median age, 40.8 y) from the French NutriNet-Santé prospective cohort study (2009–2019) were included (median follow-up time, 5.9 y). Sugar intake was assessed using repeated and validated 24-h dietary records, designed to register participants’ usual consumption for &gt;3500 food and beverage items. Associations between sugar intake and cancer risk were assessed by Cox proportional hazard models adjusted for known risk factors (sociodemographic, anthropometric, lifestyle, medical history, and nutritional factors). Results Total sugar intake was associated with higher overall cancer risk (n = 2503 cases; HR for quartile 4 compared with quartile 1: 1.17; 95% CI: 1.00, 1.37; Ptrend = 0.02). Breast cancer risks were increased (n = 783 cases; HRQ4vs.Q1 = 1.51; 95% CI: 1.14, 2.00; Ptrend = 0.0007). Results remained significant when weight gain during follow-up was adjusted for. In addition, significant associations with cancer risk were also observed for added sugars, free sugars, sucrose, sugars from milk-based desserts, dairy products, and sugary drinks (Ptrend ≤ 0.01). Conclusions These results suggest that sugars may represent a modifiable risk factor for cancer prevention (breast in particular), contributing to the current debate on the implementation of sugar taxation, marketing regulation, and other sugar-related policies. This trial was registered at clinicaltrials.gov as NCT03335644.

Therapy for mCRC is based on surgery, cytotoxic chemotherapy, and biologic agents. In randomized clinical trials, median progression-free survival (PFS) and overall survival (OS) hover around 10mo and 29mo, respectively. There are no published results on survival outcomes of patients with mCRC in Colombia. Objective: Describe the survival outcomes of patients with mCRC treated by Mauricio Lema in Medellín, Colombia. Methods: This is a retrospective, case series (2008-2020) of mCRC, ≥18 years old, treated with systemic therapy for metastatic disease, and ≥3-month follow-up. Stratification factors included: use of biologic (anti-VEGF or anti-EGFR) plus chemotherapy in 1st-Line (yes/no) and metastasectomy (yes/no). Survival analyses were evaluated using Kaplan- Meier curves. Results from the general population are described, and they are also discriminated against by the use of a biological agent in the first-line of systemic therapy. Results: 89 patients with mCRC were included. The Median follow-up was 35 months (IQR: 21-57). Median PFS and OS were 12.1mo (95%CI: 10.4-13.8) and 29.3mo (95%CI: 23.2-34.4), respectively. Median OS in patients receiving biologics was 28.8mo (95%CI: 22.1 – 35.6) vs 33.7mo (95%CI: 16.4 – 51.0) in the chemo-only group (p=0.01). Median OS in the metastasectomy and non-metastasectomy groups were 36.1 (95% CI: 26.5 - 45.7) and 25.0 months (95% CI: 15.4 - 34.5), respectively (NS). Conclusion: In this case series of patients’ survival outcomes were similar to thosereported in large phase III trials. A small sample size precludes any conclusion as to the impact of biologic agents on survival in this study.

Objetivos: el propósito de este estudio es establecer la supervivencia global de cáncer colorectal metastásico. Secundarios: 1. describir la supervivencia libre de progresión de cáncer colorectal metastásico; 2. describir las características clínicas de cáncer colorectal metástasico. Materiales y métodos: se trata de un estudio observacional descriptivo, se analizó la información entre el 1° de enero de 2008 hasta el 31 de octubre de 2019; se incluyeron todos los pacientes mayores de 18 años con diagnóstico de cáncer colorectal metastásico. Se realizaron análisis descriptivos utilizando medidas de tendencia central, ubicación y dispersión para las variables continuas, frecuencias absolutas y relativas para las variables categóricas. Se construyeron curvas de supervivencia con el método del Kaplan-Meier. Resultados: se identificaron 121 pacientes en el estudio, con edad promedio de 60.9 años (rango21-91), sexo masculino 64 (52.9 %), estado funcional 0-1: 117 (96.7 %), presentación metastásica inicial 73 (60.3 %). El tumor más frecuente fue en colon izquierdo 84 (69.4 %), sitio metástasis peritoneal 42 (34.7 %), pulmón 54 (44.6 %), hígado 61 (50.4 %), únicas 68 (56.2 %), múltiples 53 (43.8 %). Kras mutado 48 (40.0 %), Nras 14 (11.7 %), Braf 1 (0.8 %). Tipo histológico adenocarcinoma convencional 104 (86.7 %), metastasectomía curativa 9 (7.4 %), recibieron quimioterapia de primera línea 117 (96.7), folfox beva 42 (35.6 %), folfiri beva 12 (10.2 %), folfox anti egfr 19 (16.2 %), folfiri anti egfr 5 (4.3 %), fluoropirimidinas beva 16 (3.7 %). A una mediana de seguimiento de 27 meses, la tasa de mortalidad es de 94 (77.7 %), la supervivencia media libre de progresión fue 17.2 meses y de supervivencia global fue de 33 meses. Conclusiones: entre los pacientes con cáncer colorectal metastásico se presenta una supervivencia global y libre de progresión que se asemeja a la publicada en la literatura. Se requiere tamaño muestra mayor y hacer estudios analíticos y prospectivos.

Abstract Myelofibrosis (MF) is associated with splenomegaly, cytopenias, constitutional symptoms, and bone marrow fibrosis, with limited therapeutic options. Currently only two Janus kinase inhibitors (JAKi) are approved for MF worldwide. Jaktinib, an oral novel JAKi is under investigations. We present the results from a Phase 2 open-label and multi-center study, evaluated two different regimens of Jaktinib in patients (pts) with MF. Aims: To investigate the efficacy, safety and pharmacokinetics (PK) of Jaktinib in MF pts. Methods: Eligibility: MF pts included primary per WHO criteria (2016) or post-essential thrombocythemia / polycythemia vera MF according to IWG-MRT criteria; DIPSS-PLUS ≥ int-2 (int-1 with symptomatic splenomegaly/hepatomegaly required a treatment). From 21 study sites, 104 pts were randomized by 1:1 ratio to Jaktinib 100mg BID or 200mg QD during the first stage, then 14 additional were enrolled to Jaktinib 100mg BID in the second stage, total 118 pts participated in the study. The primary endpoint: the proportion of pts with spleen volume reduction from baseline ≥ 35% (SVR35) at week 24 (W24), assessed by Independent Review Committee based on MRI/CT images. Secondary endpoints: at W24 compared to baseline, the proportion of pts with ≥ 50% reduction on MPN-SAF TSS, improvements in RBC transfusion and hemoglobin (Hgb), safety profiles as well as the PK characteristics, etc. Results: 118 pts who completed treatments of 24 weeks or planned visits were summarized. Baseline characteristics were generally balanced between the two groups, and shown in Table 1. At W24, the SVR35 were 51.5% (34/66) in the 100mg BID and 28.8% (15/52) in the 200mg QD (p=0.0151), the median duration of response has not reached yet for the 100mg BID and 11.0 months for the 200mg QD. The median time to achieve a first SVR35 was 5.5 months and 11.0months, respectively. The proportion of pts achieved ≥50% improvement in TSS at W24 from baseline for BID and QD arms were 63.6% (42/66) and 53.8% (28/52), respectively. The mean percent of TSS change from baseline was -62.00 and -42.01, respectively. Approximately 35.6% (21 /59) of combined 59 pts whose baseline's Hgb ≤100g/L had elevated ≥20g/L at W24. Of the 6 pts who were transfusion-dependent at baseline, 2 pts became transfusion-independent after treatment. In addition, 5 (71.4%) out of 7 pts had a RBC infusion decreased ≥50%. The most common Grade ≥3 hematological TEAEs (≥ 5%) were anemia (100mg BID 24.2%, 200mg QD 28.8%), thrombocytopenia (16.7%, 11.5%), neutropenia (3.0%, 11.5%), and leukopenia (0, 7.7%). Most common non-hematological (of any grade) TEAEs (≥10%) were upper respiratory tract infection (24.2%, 30.8%), elevated creatinine (19.7%, 30.8%), elevated ALT (24.2%, 21.2%) and elevated bilirubin (24.2%, 13.5%), predominantly in Grade 1 or 2. A total 64 (54.2%) of the combined 118 pts had ≥ 1 dose adjustment/interruption, mostly due to thrombocytopenia (31.4%), anemia (22.0%), and neutropenia (8.5%), while 10 (10.2%) pts discontinued the treatment because of adverse events (thrombocytopenia[n=3], anemia[n=2，with 1 pts occurring pneumonia at the same time], pneumonia[n=1], tuberculosis[n=2], upper gastrointestinal bleeding[n=1], chronic kidney disease[n=1]). Total 23 (100mg BID 12 and 200mg QD 11) pts had their blood PK samples collected per protocol schedule. After single oral administration, the median T max is 2h and the average t 1/2 is 3~4 h in both groups. The AUC 0-24 of Jaktinib and its metabolites on the first day were comparable in both groups. After multiple doses, in comparison to 200mg QD, 100mg BID had a decreased C max and an increased C trough, resulting in less fluctuation between the peak and trough concentrations, which indicated that continual inhibitions of JAK-STAT pathway may result in better clinical outcomes. Summary/Conclusion: Jaktinib as a novel JAKi is generally well-tolerated and safe in Chinese MF pts. Significant reductions in spleen volume and constitutional symptom burden were observed in the 100mg BID, and also a sign of improvement was shown in RBC transfusion dependency and Hgb levels after Jaktinib treatment. Follow-up study is on-going and will provide long-term efficacy and safety data of Jaktinib. Figure 1 Figure 1. Disclosures Zhou: Suzhou Zelgen Biopharmaceuticals Co.,Ltd.: Honoraria. Jiang: Suzhou Zelgen Biopharmaceuticals Co.,Ltd.: Honoraria. Wu: Suzhou Zelgen Biopharmaceuticals Co.,Ltd.: Honoraria. Zhuang: Suzhou Zelgen Biopharmaceuticals Co.,Ltd.: Honoraria. Li: Suzhou Zelgen Biopharmaceuticals Co.,Ltd.: Honoraria. Wang: Suzhou Zelgen Biopharmaceuticals Co.,Ltd.: Honoraria. Huang: Suzhou Zelgen Biopharmaceuticals Co.,Ltd.: Honoraria. Zhu: Suzhou Zelgen Biopharmaceuticals Co.,Ltd.: Honoraria. Zhang: Suzhou Zelgen Biopharmaceuticals Co.,Ltd.: Honoraria. Du: Suzhou Zelgen Biopharmaceuticals Co.,Ltd.: Honoraria. Xiang: I agree not to accept honoraria or reimbursement, including travel support, from ineligible companies for my role as a chair/moderator/presenter in the accredited portions of this activity: Honoraria. Zhang: The content I am responsible for will be free of logos or other corporate identifiers of healthcare industry companies, specifically those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or : Honoraria. Hu: Astellas Pharma, Inc.: Research Funding. Liu: The content I am responsible for will be free of logos or other corporate identifiers of healthcare industry companies, specifically those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or : Honoraria. Jin: The content I am responsible for will be free of logos or other corporate identifiers of healthcare industry companies, specifically those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or : Honoraria. Sun: The content I am responsible for will be free of logos or other corporate identifiers of healthcare industry companies, specifically those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or : Honoraria. Zhou: The content I am responsible for will be free of logos or other corporate identifiers of healthcare industry companies, specifically those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or : Honoraria.

Abstract Background: The FDA approved rFVIIa (NovoSeven®RT) in 1999 for treatment of CHwI patients (pts) and it has been studied in compassionate/emergency use programs, clinical trials, and registries for nearly 30 years in this indication. US prescribing information directs that initially, treatment should be instituted under supervision of a physician. While home treatment is common in hemophilia including patients with inhibitors in clinical studies, scientific publications often omit the treatment location. Recent information requests in relation to policy decisions by payers around home use of rFVIIa prompted systematic analysis of clinical studies and registries where predominant use was in the home setting. Aim: To analyze rFVIIa safety and efficacy data in home treatment in clinical trials and registries. Methods: A systematic review focusing on the efficacy and safety of rFVIIa for the management of congenital hemophilia A and B patients with inhibitors in the home setting was performed. Studies included in the review consisted of clinical trials (phase I-IV) and prospective and retrospective registries evaluating bleed management and prophylaxis. Results: A detailed review identified 14 studies for treatment of bleeding (3 phase II, 2 phase III, 9 phase IV) in the home setting including studies reporting on standard doses (90 mcg/kg), high single doses (270 mcg/kg), and observational studies (dosing per physician direction). These studies captured 865 patients treated for 9,024 bleeding episodes (see Table 1), including 640 patients with 6,999 episodes in studies where efficacy was evaluable. Efficacy was consistently high across studies. The 10-year Japanese post-marketing study (F7HAEM-1947) required all adverse events to be reported irrespective of causality; one patient had visual field defect and suspected cerebral infarction, one central venous occlusion, and two others had events that are not clearly thrombotic (hemolytic uremic syndrome, acute renal failure). The only thromboembolic event (TE) reported in phase II-III studies was in 1 patient in the phase II adept™2 trial, which compared vatreptacog alpha with rFVIIa. Apart from the Japanese study, thrombotic rate was 1/7306 bleeds (0.014%). Table 1. On demand treatment of bleeding with rFVIIa Trial ID Phase Number of Patients Number of Bleeds Efficacy Safety F7HAEM-1510 II 22 42 88% No TE F7HAEM-2068 II 24 45 91-92% No TE NN7128-1907 (Pioneer 1) II 23 359 84% No TE F7HT/USA/1/USA (US Home Trx) III 56 877 92% No TE NN1731-3562 (adept™2) III 57 227 93% 1 TE HRS/HTRS Registry (2000-2003) IV 42 793 87% No TE HTRS Registry (2004-2008) IV 129 2,041 89-93% No TE F7HAEM-1965 (DOSE) IV 35 158 Not assessed (diary) No TE F7HAEM-3507 (ONE) IV 102 496 85-96% No TE NN7025-3601 (SMART-7) IV 51 511 Not reported (interim) No TE F7HAEM-3537 (UKHCDO Registry) IV 139 1,356 Not reported (diaries) No TE F7HAEM-1947 IV 144* 1,718* 88% 2TE† F7AHEM-1921 (WIRK Registry) IV 14 269 90% No TE F7HAEM-3850 IV 27 132 81%-92% No TE Total 865 9,024 * Patients with evaluable efficacy. † One visual field defect with suspected cerebral infarction, one central venous occlusion. Two studies evaluated rFVIIa for secondary prophylaxis (1 phase II, 1 phase IV) (see Table 2). The phase II study captured 22 patients treated with 90 or 270 mcg/kg daily. The phase IV retrospective study captured 86 patients with varied rFVIIa doses that often changed over time. Effective reduction in bleeding was seen in both studies. Across 108 patients treated with prophylaxis at home over 42,861 days, there were no thrombotic events reported. Table 2. Secondary Prophylaxis with rFVIIa Trial ID Phase Number of Patients Number of Prophylaxis Days Efficacy Safety F7HAEM-1505 II 22 1,885 45-59% reduction No TE F7HAEM-3695 (PRO-PACT) IV 86 40,976 46-52% No TE Total 108 42,861 Conclusions: Analysis of data from clinical studies of rFVIIa in home treatment of bleeding and secondary prophylaxis of bleeding demonstrates consistent efficacy for treatment and prevention of bleeding. Thrombotic events were uncommon across ~9,000 bleeding episodes and not reported in ~43,000 prophylaxis days. These data support the safety and efficacy of rFVIIa in the home treatment setting and sufficient evidence for payers to continue its approval in the home management of hemophilia patients. Disclosures Young: Kedrion: Consultancy; Bayer: Consultancy; Baxter: Consultancy; Biogen Idec: Consultancy, Honoraria; Novo Nordisk: Consultancy, Honoraria. Escobar:Novo Nordisk Inc.: Consultancy; Baxter: Consultancy; Bayer: Consultancy; Pfizer: Consultancy; Biogen: Consultancy; CSL Behring: Consultancy. Pipe:Biogen Idec Inc: Consultancy; CSL Behring: Consultancy; Bayer: Consultancy; American Thrombosis and Hemostasis Network: Other: Chair of the Board of Directors; National Hemophilia Foundation: Other: member of the Medical and Scientific Advisory Committee; Novo Nordisk: Consultancy; Baxter: Consultancy. Cooper:Novo Nordisk Inc.: Employment.

Abstract Background: Isavuconazole (ISA) is a novel, water-soluble, triazole agent, with broad-spectrum antifungal activity. The SECURE trial (NCT00412893), a Phase III, randomized, double-blind study, investigated the efficacy and safety of ISA vs. voriconazole (VRC) in patients with invasive fungal disease caused by Aspergillus spp. or other filamentous fungi. Patients undergoing hematopoietic stem cell transplant (HSCT) are at particular risk of developing invasive aspergillosis (IA), which is associated with a high mortality in this population. The outcomes in HSCT patients with IA enrolled in SECURE are presented here. Methods: Patients with proven/probable/possible invasive mold disease were randomized 1:1 to receive ISA or VRC. Patients in the ISA arm received ISA 200mg IV TID for 2 days, followed by 200mg QD (IV or PO) thereafter. Patients in the VRC arm received VRC6mg/kg IV BID on Day 1; 4mg/kg IV BID on Day 2; then either 4mg/kg IV BID or 200mg PO BID. Antifungal therapy was given up to 84 days. The primary endpoint was all-cause mortality on Day 42. Overall treatment success (clinical, mycological, and radiological) at end-of-treatment (EOT), safety, and tolerability were also analyzed in HSCT patients with proven or probable IA who received at least one dose of the study drug (mycological intent-to-treat population [myITT]). All outcomes were assessed by an independent data review committee. Results: Of the 527 patients randomized for the SECURE trial, 67 patients with proven or probable IA had a history of HSCT (ISA: n=38; VRC: n=29). Fifty four (80.6%) patients had received an allogeneic stem cell transplant, 32 (47.8%) were neutropenic, and 26 (38.8%) had graft-vs-host disease (GVHD). Mortality was higher in patients with neutropenia (37.5%) compared with those without neutropenia (14.3%; adjusted difference: 17.8; 95% confidence interval: –0.09, 35.6); and, was higher in patients without GVHD (32.6%) compared with those with GVHD (15.4%; adjusted difference; –13.2; 95% confidence interval: –35.3, 8.9). The highest mortality was observed in HSCT patients with neutropenia (Table 1). Treatment-emergent adverse events (TEAEs) were reported in 94.7% (ISA) and 100% (VRC) of patients, and drug-related TEAEs in 36.8% (ISA) and 62.1% (VRC) of patients (P=0.051). The percentages of TEAEs in most System Organ Classes were lower in the ISA arm, although the difference between arms only reached statistical significance for cardiac disorders (ISA 15.8% vs. VRC 41.4%; difference –0.256, asymptotic 95% confidence interval: –0.47, –0.04; P=0.027). Conclusion: In this large, prospective, randomized study, IA was shown to adversely affect the outcomes of HSCT patients. Patients with neutropenia at the time of diagnosis had the highest rate of mortality. ISA was demonstrated to be efficacious for the primary treatment of IA in HSCT patients. The analyses of adverse events suggest a safety advantage of ISA compared with VRC. Abstract 1133. Table 1. Efficacy outcomes (myITT population) Outcome ISA arm VRC arm Adjusted difference % (95% CI) Total (ISA+VRC) N Event (%) N Event (%) Event/N (%) All-cause mortality at Day 42 a All HSCT patients 38 8 (21.1) 29 9 (31.0) –7.5 (–25.8, 10.8) 17/67 (25.4) Allogeneic HSCT 32 7 (21.9) 22 6 (27.3) –2.1 (–22.8, 18.6) 13/54 (24.1) Non-allogeneic HSCT 6 1 (16.7) 7 3 (42.9) –38.5 (–72.2, –4.7) 4/13 (30.8) With neutropenia 21 6 (28.6) 11 6 (54.5) –26.0 (–69.6, 17.6) 12/32 (37.5) With GVHD 13 2 (15.4) 13 2 (15.4) 0.4 (–23.4, 24.2) 4/26 (15.4) Without GVHD 26 7 (26.9) 17 7 (41.2) –15.9 (–43.4, 11.5) 14/43 (32.6) Overall success at EOTb 38 10 (26.3) 29 9 (31.0) 4.5 (–13.5, 22.5) 19/67 (28.4) Clinical response at EOT 34 19 (55.9) 28 13 (46.4) –5.8 (–27.1, 15.5) 32/62 (51.6) Mycological response at EOT 38 11 (28.9) 29 9 (31.0) 2.5 (–15.5, 20.4) 20/67 (29.9) Radiological response at EOT 38 8 (21.1) 29 8 (27.6) 8.0 (–9.4, 25.5) 16/67 (23.9) a Adjusted treatment difference calculated for ISA−VRC b Adjusted treatment difference calculated for VRC−ISA Disclosures Heinz: Astellas, Gilead Science, Janssen-Cilag, MSD Sharp & Dohme/Merck, Pfizer : Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau. Off Label Use: Isavuconazole for the treatment of aspergillosis (Marketing Authorization Application has been submitted by Astellas (FDA ) and Basilea (EMA)).. Cornely:Astellas: Consultancy, Honoraria, Research Funding, Speakers Bureau. Franks:Astellas: Employment. Shi:Astellas: Employment. Azie:Astellas: Employment. Maertens:Astellas: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau.

Abstract Introduction: The BCL-2 inhibitor venetoclax (Ven) has been approved on monotherapy or combined with rituximab in relapsed/refractory CLL patients (pts) and combined with obinutuzumab in previously untreated CLL pts. However, evidence from clinical trials can be difficult to generalize to real-world patient populations. The VENARES study assesses the real-world use of Ven following approval to inform of subpopulations underrepresented in clinical trials. Methods: This is Spanish non-interventional retrospective, multicenter post-marketing observational study. The main objective was to evaluate the effectiveness of Ven in adult CLL pts by the overall response rate (ORR) at 9 months (mo) after the first Ven dose administration. Secondary objective was to evaluate the effectiveness for the Ven monotherapy and the Ven combined with rituximab subpopulations. Consecutive adult pts with diagnosis of CLL who have initiated Ven at least 9 mo before the inclusion in the study were included. Data of pts are retrospectively reviewed until the date of last follow-up or death. Results: 125 pts diagnosed with CLL and who met the eligibility criteria were analyzed. The median age was 72 years (67 - 77) with 76.8% being older than 65 years. Most patients were male (68.8%), had a concurrent disease (65.6%). ECOG PS was recorded in 76 pts: 40 pts (32%) had PS 0, 30 pts (24%) PS 1 and 6 pts (4.8%) PS 2. Pts had received a median of 4 prior lines of therapy (range 1-13 lines). At baseline, among the 92 pts with known Binet stage, 31 (33.7%) had stage C and 38 (41.3%) had stage B; bulky nodes ≥ 5 cm were present in 20 of 87 pts; 49 pts (39.2%) had an absolute lymphocyte count ≥ 25 x 10 9/L and 33 of 54 pts (61%) baseline beta-2 microglobulin value above of 3500 ng/mL. In total, 29 of 90 patients (32%) assessed had Cr 17p deletion, 28 of 86 patients (32%) tested had TP53 mutations, and 46 of 56 patients (82%) who were tested had unmutated immunoglobulin heavy-chain variable (IGHV) status. Ven was administered as monotherapy in 71 pts (57.6%), combined with rituximab in 36 pts (28.8%), combined with obinutuzumab in 5 pts (4%) and combined with other drugs in 13 pts (10.4%). 83 of 125 patients included were evaluable for the primary objective of the study: the ORR at 9 mo was 84.3% (70 patients): CR/CRi in 44 (53%) pts, PR/nPR in 26 pts (31.3%), SD in 9 pts (10.8%) and PD in 4 pts (4.8%). By treatment, in the evaluable patients, ORR at 9 months were 79.2% (38 of 48 patients) in the Ven monotherapy group, with 45% of CR/CRi, and 92.3% (24 of 26 patients) in the Ven combined with rituximab, with 61% CR/Cri. The median duration of PFS was not reached at the time of the analysis (1-June-2021). Kaplan-Meier estimates of the probability of PFS at 24 mo was 75.4% (95% CI, 58.2 - 86.3). Disease progression occurred in 21 pts. Assessment of minimal residual disease (MRD) was available for 32 patients (25.6%) on the basis of peripheral-blood samples, bone marrow or both. Best undetectable MRD was reached in fourteen patients (43.8%). uMRD was more common in pts treated with Ven combined with R (83.3%, 5 of 6 pts) than in pts treated with Ven monotherapy (33.3%, 7 of 21 pts). Adverse events (AEs) were reported during Ven therapy in all 125 patients, 93 of these pts reported AEs related to Ven. Related to Ven, 67 patients (53.6%) experienced at least one AE: 52 pts (41.6%) had neutropenia being grade 3 and 4 in 22 (42.3%) and 9 (17.3%) pts, respectively. 9 pts (7.2%) had febrile neutropenia. Thrombocytopenia and anemia were less common occurring in 5.6% and 2.4%, respectively. Tumor lysis syndrome (TLS) occurred in 4 of 125 pts during ramp-up (3 laboratory and 1 clinical), 2 of them were related to Ven both lab TLS. None of the pts discontinued therapy due to TLS. Richter transformation was observed in 6 pts (4.8%). Other common AEs was diarrhea (10.4%), but most cases were mild. Conclusions: Our first real-world data show that Ven monotherapy or combined with rituximab is effective in highly pre-treated CLL patients, ORR at 9 mo was 84.3% in all population and PFS estimate at 24 mo was 75.4% with similar outcomes to those in the pivotal clinical trials. The safety profile of Ven was consistent with prior experience of Ven in monotherapy or combined with rituximab and no new safety signals were detected. Disclosures Baltasar: Janssen, Abbvie: Consultancy. Terol: Roche: Membership on an entity's Board of Directors or advisory committees, Other: Travel; BMS: Consultancy; Roche: Consultancy; Gilead: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Research Funding; Abbvie: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Travel; Janssen: Membership on an entity's Board of Directors or advisory committees, Other: Travel, Research Funding; Takeda: Membership on an entity's Board of Directors or advisory committees, Other: Travel; Hospital Clinico Valencia: Current Employment. Moreno: Janssen, Abbvie: Research Funding; Abbvie, Janssen, AstraZeneca: Speakers Bureau; Abbvie, Janssen, AstraZeneca, Beigene: Membership on an entity's Board of Directors or advisory committees. Osorio: Janssen, Abbvie, Roche: Consultancy. De la Cruz: Abbvie: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Beigene: Membership on an entity's Board of Directors or advisory committees; EUSA Pharma: Membership on an entity's Board of Directors or advisory committees; JANSSEN: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Kyowa Kirkin: Membership on an entity's Board of Directors or advisory committees; Roche: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Takeda: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. de la Serna: AbbVie, AstraZeneca, Roche: Speakers Bureau; ABBVIE, ASTRAZENECA,ROCHE: Research Funding; AbbVie, AstraZeneca, Beigene, Gilead, GSK, Janssen, Jazzpharma, Novartis, Roche: Consultancy. Arguiñano: Takeda, Sanofi, Janssen, BMS-Celgene, Abbvie: Speakers Bureau; Takeda, Sanofi, Janssen, BMS-Celgene, Abbvie: Consultancy. Loscertales: Janssen, Abbvie, Roche, Gilead: Speakers Bureau; Janssen, Abbvie, Astra-Zeneca, Beigene, Roche, Gilead: Consultancy. García: Janssen, Roche, Gilead, Celgene: Consultancy; Janssen, AbbVie: Research Funding; Janssen, Roche, Gilead, AbbVie, Celgene: Other: medical meetings funding. Pérez Persona: BMS/Celgene: Consultancy, Other: Support for attending meetings and/or travel, Speakers Bureau; Amgen: Consultancy, Other: Support for attending meetings and/or travel, Speakers Bureau; Takeda: Speakers Bureau; AbbVie: Other: Support for attending meetings and/or travel, Speakers Bureau; Sanofi: Consultancy, Speakers Bureau; AstraZeneca: Speakers Bureau; GSK: Consultancy; Incyte: Consultancy. Pérez-Encinas: Janssen: Consultancy. Caballero: Celgene, Janssen, Novartis, Abbvie: Speakers Bureau; Celgene, Janssen, Amgen: Consultancy. Ruiz-Zorrilla: Abbvie: Current Employment. Moreno: abbvie: Current Employment. Ferrà: Janssen, Roche, Gilead, Takeda, Abbvie: Consultancy; Janssen, Roche, Gilead, AbbVie: Other: medical meetings funding.

Vegetables are considered important agricultural commodities for consumer , because they contain proteins carbohydrate, oil, and vitamins. There is an increasing demand for these products which makes the process to reach the consumer in suitable prices a necessary task . Agricultural marketing has an important role in making the price for these products especially the agricultural marketing . the object of this paper is to calculate the marketing margin for some vegetable crops, like tomatoes, cucumber, onions and potatoes, between whole sale price and consumer price in Baghdad province and to calculate the relative importance for marketing margin items. The research arrived to some results like that the marketing margin between wholesale price and consumer price represents an important part of what consumer spends as it was about 35.6% for tomatoes, 39.0% for cucumber, 23.0% for eggplant, and 36.6% for potatoes, 35.8% for onions and as average for all vegetables was about 34.1 % the relative importance of marketing margin components came in the first place , the profits of retailer as it was on average for all vegetables about 42.6% and in the second place was come transportation costs as it relative importance was on average about 18.8% while the relative importance of marketing operations was 17.7%. And then came the marketing operations, packaging and loading costs.

This research was made to understandand analyze how big is the influence of marketing mix service toward customer loyalty using tourist service Taman Air Panas Drajat Pass. A method used in this research about the influence of marketing mix service toward customer loyalty arefield observation method, interview, questionnaire, and literature study using liker scale. In samle determination, the writer usedaccidental sampling method for about 90 samles whereas the approximation method used in data analysis methodis Linearregression method which has the function to know the relationship between independent variable, that is marketing mix (X) with dependent variable, that is customer loyalty (Y). The research showed us that marketing mix consist of: product (X1), price (X2), place (X3), promotion (X4), physical evidance (X5), people (X6),and (x7) simultaneously has a significant. Effect toward customer loyalty (Y). But partially, the one who has a significant effect toward customer loyalty is variableprocess with the significantlevel that is 0,017. This marketing mix can expalin that customer loyalty of Taman Air Panas Darajat Pass is 0,356 or 35,6% while the rest of it, that is 64,4% is the customer loyalty that has not been explained by customer’s attitude, purchasing conviction variable, evaluation variable normative conviction variable and motivation variable.

Charomatophores are colour bearing cells, responsible for colouration and colour changes in animals specially in freshwater Crustaceans. As animal’s integument comes in direct contact with the environment therefore they may provide foremost information of the changes in surroundings. Freshwater prawns, M. lamarrei were subjected to low (200C ± 20C), normal (260C ± 20C) and high temperature (350C ± 20C) showed remarkable changes in colouration, chromatophore number and structure. Animals became dark coloured at low temperature while lighter in colouration at high temperature in comparison to the animals kept at normal temperature. Most of the chromatophores were in stellate and punctate stage in low and high temperature respectively in comparison to reticulate stage at normal temperature. Mechanism of colour change as well as importance of colour in marketing value of freshwater prawns has been discussed.

Abstract Background For patients with recurrent flares of gout, tophi, urate crystal arthropathy, and renal stones, urate-lowering therapies (ULTs, including allopurinol and febuxostat) are the first-line treatment. Due to the widespread use of these ULTs (especially in patients with impaired renal function), assessment of the associated renal risk is essential. Accordingly, we performed a disproportionality analysis of reported cases of acute renal failure (ARF) associated with allopurinol and febuxostat. Methods We carried out a case/non-case study of the World Health Organization’s VigiBase® pharmacovigilance database between January 1, 2008, and December 31, 2018. The frequency of reports of ARF as a standardized Medical Dictionary for Regulatory Activities query for allopurinol and febuxostat was compared with that of all other reports for the two drugs and quoted as the reporting odds ratio (ROR) [95% confidence interval (CI)]. The results’ stability was assessed in a series of sensitivity analyses (notably after the exclusion of putative competing drugs). Results Among 3509 “suspected drug” notifications for febuxostat and 18,730 for allopurinol, we identified respectively 317 and 1008 cases of ARF. Acute renal failure was reported significantly more frequently for febuxostat and allopurinol than for other drugs (ROR [95%CI] 5.67 [5.05–6.36] and 3.25 [3.05–3.47], respectively). For both drugs, the ROR was higher in women than in men, respectively 11.60 [9.74–13.82] vs. 3.14 [2.69–3.67] for febuxostat and 4.45 [4.04–4.91] vs. 2.29 [2.11–2.50] for allopurinol. The sensitivity analyses confirmed the disproportionality for these two ULTs. Conclusions Acute renal failure was reported respectively 5.7 and 3.3 times more frequently for febuxostat and for allopurinol than for other drugs. Due to the potential consequences of ARF, physicians should take account of this disproportionality signal when prescribing the ULTs febuxostat and allopurinol.

According to the World Health Organization, iron deficiency anemia affects more than 30% of the world's population. In the Russian Federation, anemia is diagnosed in 35,6% of pregnant women, and the prevalence rate among children in the first year of life is about 83,8 ‰. In the Stavropol Territory, more than 10 thousand cases of anemia are registered annually, of which half are the first. More than 20% of these cases are diagnosed in children and adolescents. In this regard, there is a steady dynamics in the consumption of a specific nomenclature of antianemic drugs at various levels of the drug supply system: federal, regional and municipal. The purpose of the work was to analyze the availability of antianemic drugs used in the treatment of patients living in the city of Pyatigorsk, Stavropol Territory. In the course of work, we used methods of content analysis, analytical, direct observation, grouping and comparison. The studies were carried out from november 2019 to february 2020 on the basis of 11 pharmacy of various legal forms included in the pharmacy chains «Vita +», «Gorzdrav», and the «Pharmacy Warehouse» located in Pyatigorsk. When studying the pharmaceutical range of antianemic drugs, it was found that at the municipal level it includes 12 trade names of drugs based on Fe2+ and Fe3+ ions. Analysis of the liquidity of the prices of antianemic drugs in the pharmacies of Pyatigorsk and the solvency of the population showed the economic affordability of most of the studied range of drugs for patients. An analysis of the width and depth of the range of antianemic drugs for the treatment of iron deficiency anemia revealed the presence of reserves for increasing the range of products for patients. It is concluded that it is necessary to consolidate the efforts of medical and pharmaceutical workers to expand the range of antianemic drugs used by patients, which will increase the quality of medical care.

Grading of arecanuts before marketing fetches better prize. There are two universally accepted grading systems for arecanuts namely grading at the producers’ level and grading at the wholesale traders’ level. The major work in this paper is devoted to generation of a standard image database for the White Chali Type arecanuts and constructing a frame work for their grading by exploring the features of White Chali Type arecanut images for the first time. Further, two separate datasets are developed for the above grading systems by employing image feature extraction methods with 3500 and 4132 instances respectively. The arecanuts are graded using popular machine learning algorithms and the results are validated using ten fold cross validation. Multinomial logistic regression as classifier outperformed with classification accuracies of 98.8% and 92.69% for the producers’ level and the whole sale traders’ level grading systems respectively. Also the performances of various machine learning algorithms for the above two datasets are evaluated using weighted average values of True Positive rate, False Positive rate, precision, recall, F-measure and Cohen’s Kappa coefficient.

Rice is important cereal crops cereals crop worldwide. Kalanamak is heritage rice of eastern Uttar Pradesh and valued for its aroma, taste and nutritive quality. Four improved varieties, KN3, Bauna Kalanamak 101, Bauna Kalanamak 102 and Kalanamak Kiran were released in 2010, 2016, 2017and 2018 respectively. Last three varieties yield 50% more than traditional Kalanamak KN3 and mature 10 days earlier. Normal selling price of the Kalanamak paddy ranges between Rs. 2500/- to Rs. 3500/- per quintal. Organic Kalanamak fetches 20% premium over normal Kalanamak. Summarily compared to Rs. 17,500 / ha net profit from common HYV rice, Kalanamak KN3 will give Rs. 44,375, Bauna Kalanamak Rs. 71,500 and Organic Kalanamak Rs. 92,500 per hectare net profit, hence better net profit of the farmers is assured sustainably. Kalanamak is heritage rice of eastern Uttar Pradesh and valued for its aroma, taste and nutritive quality. Its cultivation declined from 50,000 ha to less than 2,000 ha due to varietal deterioration and competition from HYV. Four improved varieties, KN3, Bauna Kalanamak 101, Bauna Kalanamak 102 and Kalanamak Kiran were released in 2010, 2016, 2017and 2018 respectively. Last three varieties yield 50% more than traditional Kalanamak KN3 and mature 10 days earlier. Normal selling price of the Kalanamak paddy ranges between Rs. 2500/- to Rs. 3500/- per quintal. In spite of MSP announced by the governments, most farmers sell their HYV paddy around Rs. 1300/- per quintal. Cost of cultivation of Kalanamak and yield the same as HYV now, farmers get three times more net profit. Organic Kalanamak fetches 20% premium over normal Kalanamak. Summarily compared to Rs. 17,500 / ha net profit from common HYV rice, Kalanamak KN3 will give Rs. 44,375, Bauna Kalanamak Rs. 71,500 and Organic Kalanamak Rs. 92,500 per hectare net profit. With the PRDF arranged contract growing, by involving farmers and marketing companies from Kharif 2018, tripling the net profit of the farmers is assured sustainably. Thus, the proverb “Paddy and Poverty go together” is a myth now.

Purpose The purpose of this paper is to show how sonic logos, despite their brief exposure time, resonate with consumers’ emotions and attitudes in a manner that until now has been attributed to only longer background music in advertising. The moderating role of sonic logo placement within the ad (beginning versus ending) and the mediating role of emotion felt after exposure to the brand and advertisement are also explored. Design/methodology/approach An expansion on sonic logo research is completed through two experiments testing nine hypotheses. A pretest is also conducted to create two orthogonal sonic logos (sad sonic logo and happy sonic logo) which are then used in the two experiments. Findings Participants had higher attitude scores for an advertisement that had a happy sonic logo over the ad that had a sad sonic logo. These consumer attitudes are mediated by emotion felt because of the exposure to the brand and advertisement and are moderated by placement of the sonic logo within the ad. Placement drove more positive consumer attitudes of a sad sonic logo at the beginning and a happy sonic logo at the end of the advertisement. Practical implications Given the short nature of a sonic logo, sonic logo placement in the advertisement is shown to change consumer perceptions. This effect uncovers an important aspect of placement of the sonic logo in the advertisement which gives practitioners a means of application. Furthermore, consumer emotions drive these strong attitudes despite the short exposure times of the sonic logo. Originality/value This paper expands upon the limited sonic logo research and shows how the short exposure time of a sonic logo can have the same emotional qualities as long-form music, previously reserved for background music in advertising. In addition, by uncovering the mediating relationship of emotion felt after exposure to the brand and advertisement, it is shown how these short audio branding elements can help shape emotion and consumer attitude toward brands. Finally, altering placement of the sonic logo can enhance consumer attitudes of the advertisement and brand.

Purpose The purpose of this paper is to investigate how consumers’ luxury purchase behavior has been affected by COVID-19. A theoretical framework is proposed to determine how isolation leads to intention to purchase luxury brands through bandwagon luxury consumption behavior. Additionally, the moderating effects of COVID-19 anxiety and social capital on the relationship between bandwagon luxury consumption behavior and subjective well-being and intention to purchase luxury brands are tested. Design/methodology/approach Survey responses from a national sample of 261 luxury consumers in the USA were collected. The data were analyzed using a covariance-based structural equation modeling technique. Findings The results confirm that the feeling of isolation leads to a higher intention to purchase luxury brands. Both COVID-19 anxiety and social capital moderate the relationship between bandwagon luxury consumption behavior and intention to purchase luxury brands/subjective well-being related to the luxury brand purchase. Research limitations/implications Luxury marketers should focus on highlighting bandwagon elements of their brands, such as their popularity and how they enhance social connectedness when tailoring their brand communication to isolated consumers. The data is limited to luxury consumers in the USA; thus, the findings are specific to the US market. Originality/value Given the paucity of research on luxury consumption for isolated consumers, this study adds to the literature on luxury brands by examining how the feeling of isolation affects the intention to purchase luxury brands.

Abstract Introduction Vape shops represent prominent, unique retailers, subject to Food and Drug Administration (FDA) regulation in the United States. Aims and Methods This study assessed compliance of US vape shop retail marketing strategies with new regulations (eg, required age verification, prohibited free samples) and pre-implementation conditions for other regulations (eg, health warning labels on all nicotine products, required disclosures of e-liquid contents). Results 95.0% of shops displayed minimum-age signage; however, mystery shoppers were asked for age verification at 35.6% upon entry and at 23.4% upon purchase. Although 85.5% of shops had some evidence of implementing FDA health warnings, 29.1% had signage indicating prohibited health claims, 16.3% offered free e-liquid samples, 27.4% had signage with cartoon imagery, and 33.3% were within two blocks of schools. All shops sold open-system devices, 64.8% sold closed-system devices, 68.2% sold their own brand of e-liquids, 42.5% sold e-liquids containing cannabidiol, 83.2% offered price promotions of some kind, and 89.9% had signage for product and price promotions. Conclusions Results indicated that most shops complied with some implementation of FDA health warnings and with free sampling bans and minimum-age signage. Other findings indicated concerns related to underage access, health claims, promotional strategies, and cannabidiol product offerings, which call for further FDA and state regulatory/enforcement efforts.

A low-cost charcoal evaporative cooler was designed and tested for the storage of camel milk in an arid pastoral area of northern Kenya. The cooler, 0.75 m3 in capacity, was made of galvanised iron frame reinforced with wire mesh inside and out, leaving a 10 cm-wide cavity which was filled with charcoal. A water reservoir linked to the cooler at the top through a perforated pipe kept the charcoal continuously wet through drip system. A wind driven fan on the roof enhanced air movement through the charcoal walls by sucking out the air in the cooler. The cooler was evaluated for temperature and product response. The inside temperature was 1-11°C lower than outside temperature and inside humidity was 0-49% higher than outside. During the hottest time of the day (14.00 hrs) when cooling was most needed, the cooler consistently maintained an average temperature drop of 10.5±0.4°C below ambient temperature, which varied from 29-32°C. This reduction in temperature was 35.6% and statistically significant (p≤0.05). During this time, cooling efficiency varied between 74.2 to 86.7%. Temperature of camel milk inside the cooler did not significantly increase (p>0.05) between morning time and evening time. However, temperature of control milk at ambient conditions significantly (p≤0.05) changed over the same period, from 22.6±0.08°C to 28.1±0.08°C. Milk inside the cooler was also significantly cooler (p≤0.05) than control milk in the evening, with a net temperature reduction of 27.0%. Total bacterial count changed from 31.4±2.1 x 104 cfu/ml to 43.1±1.9 x 104 and 1638±81 x 104 cfu/ml for test and control milk, respectively, after storage for 10 hours. As an inexpensive alternative to mechanical refrigeration, evaporative cooling technology is promising and suitable for rural application in arid pastoral areas without grid electricity, to minimise risk of milk spoilage at collection points and retail level, and thereby encourage organised women groups to get involved in milk marketing as a source of income.

Objective: The introduction of Bruton’s tyrosine kinase (BTK) inhibitors was a milestone in the treatment of B-cell malignancies in recent years owing to its desired efficacy against chronic lymphocytic leukaemia and small cell lymphocytic lymphoma. However, safety issues have hindered its application in clinical practice. The current study aimed to explore the safety warning signals of BTK inhibitors in a real-world setting using the FDA Adverse Event Reporting System (FAERS) to provide reference for clinical rational drug use.Methods: Owing to the short marketing time of other drugs (zanbrutinib and orelabrutinib), we only analysed ibrutinib and acalabrutinib in this study. All data were obtained from the FAERS database from January 2004 to December 2021. Disproportionality analysis and Bayesian analysis were utilised to detect and assess the adverse event (AE) signals of BTK inhibitors.Results: In total, 43,429 reports of ibrutinib were extracted and 1527 AEs were identified, whereas 1742 reports of acalabrutinib were extracted and 220 AEs were identified by disproportionality analysis and Bayesian analysis. Among reports, males were more prone to develop AEs (58.2% for males vs. 35.6% for females treated with ibrutinib, and 55.9% vs. 31.9%, respectively, for acalabrutinib), and more than 30% of patients that suffered from AEs were over 65 years of age. Subsequently, we investigated the top 20 preferred terms (PTs) associated with the signal strength of ibrutinib and acalabrutinib, and our results identified 25 (13 vs. 12, respectively) novel risk signals. Among the top 20 PTs related to death reports, the terms infectious, pneumonia, pleural effusion, fall, asthenia, diarrhoea, and fatigue were all ranked high for these two BTK inhibitors. Further, cardiac disorders were also an important cause of death with ibrutinib.Conclusion: Patients treated with ibrutinib were more prone to develop AEs than those treated with acalabrutinib. Importantly, infection-related adverse reactions, such as pneumonia and pleural effusion, were the most common risk signals related to high mortality associated with both BTK inhibitors, especially in elderly patients. Moreover, cardiovascular-related adverse reactions, such as atrial fibrillation and cardiac failure, were fatal AEs associated with ibrutinib. Our results provide a rationale for physicians to choose suitable BTK inhibitors for different patients and provide appropriate monitoring to achieve safer therapy and longer survival.

Background “The sense of taste,” write Nelson and colleagues in a 2002 issue of Nature, “provides animals with valuable information about the nature and quality of food. Mammals can recognize and respond to a diverse repertoire of chemical entities, including sugars, salts, acids and a wide range of toxic substances” (199). The authors go on to argue that several amino acids—the building blocks of proteins—taste delicious to humans and that “having a taste pathway dedicated to their detection probably had significant evolutionary implications”. They imply, but do not specify, that the evolutionary implications are positive. This may be the case with some amino acids, but contemporary tastes, and changes in them, are far from universally beneficial. Indeed, this article argues that modern food production shapes and distorts human taste with significant implications for health and wellbeing. Take the western taste for fried chipped potatoes, for example. According to Schlosser in Fast Food Nation, “In 1960, the typical American ate eighty-one pounds of fresh potatoes and about four pounds of frozen french fries. Today [2002] the typical American eats about forty-nine pounds of fresh potatoes every year—and more than thirty pounds of frozen french fries” (115). Nine-tenths of these chips are consumed in fast food restaurants which use mass-manufactured potato-based frozen products to provide this major “foodservice item” more quickly and cheaply than the equivalent dish prepared from raw ingredients. These choices, informed by human taste buds, have negative evolutionary implications, as does the apparently long-lasting consumer preference for fried goods cooked in trans-fats. “Numerous foods acquire their elastic properties (i.e., snap, mouth-feel, and hardness) from the colloidal fat crystal network comprised primarily of trans- and saturated fats. These hardstock fats contribute, along with numerous other factors, to the global epidemics related to metabolic syndrome and cardiovascular disease,” argues Michael A. Rogers (747). Policy makers and public health organisations continue to compare notes internationally about the best ways in which to persuade manufacturers and fast food purveyors to reduce the use of these trans-fats in their products (L’Abbé et al.), however, most manufacturers resist. Hank Cardello, a former fast food executive, argues that “many products are designed for ‘high hedonic value’, with carefully balanced combinations of salt, sugar and fat that, experience has shown, induce people to eat more” (quoted, Trivedi 41). Fortunately for the manufactured food industry, salt and sugar also help to preserve food, effectively prolonging the shelf life of pre-prepared and packaged goods. Physiological Factors As Glanz et al. discovered when surveying 2,967 adult Americans, “taste is the most important influence on their food choices, followed by cost” (1118). A person’s taste is to some extent an individual response to food stimuli, but the tongue’s taste buds respond to five basic categories of food: salty, sweet, sour, bitter, and umami. ‘Umami’ is a Japanese word indicating “delicious savoury taste” (Coughlan 11) and it is triggered by the amino acid glutamate. Japanese professor Kikunae Ikeda identified glutamate while investigating the taste of a particular seaweed which he believed was neither sweet, sour, bitter, or salty. When Ikeda combined the glutamate taste essence with sodium he formed the food additive sodium glutamate, which was patented in 1908 and subsequently went into commercial production (Japan Patent Office). Although individual, a person’s taste preferences are by no means fixed. There is ample evidence that people’s tastes are being distorted by modern food marketing practices that process foods to make them increasingly appealing to the average palate. In particular, this industrialisation of food promotes the growth of a snack market driven by salty and sugary foods, popularly constructed as posing a threat to health and wellbeing. “[E]xpanding waistlines [are] fuelled by a boom in fast food and a decline in physical activity” writes Stark, who reports upon the 2008 launch of a study into Australia’s future ‘fat bomb’. As Deborah Lupton notes, such reports were a particular feature of the mid 2000s when: intense concern about the ‘obesity epidemic’ intensified and peaked. Time magazine named 2004 ‘The Year of Obesity’. That year the World Health Organization’s Global Strategy on Diet, Physical Activity and Health was released and the [US] Centers for Disease Control predicted that a poor diet and lack of exercise would soon claim more lives than tobacco-related disease in the United States. (4) The American Heart Association recommends eating no more than 1500mg of salt per day (Hamzelou 11) but salt consumption in the USA averages more than twice this quantity, at 3500mg per day (Bernstein and Willett 1178). In the UK, a sustained campaign and public health-driven engagement with food manufacturers by CASH—Consensus Action on Salt and Health—resulted in a reduction of between 30 and 40 percent of added salt in processed foods between 2001 and 2011, with a knock-on 15 percent decline in the UK population’s salt intake overall. This is the largest reduction achieved by any developed nation (Brinsden et al.). “According to the [UK’s] National Institute for Health and Care Excellence (NICE), this will have reduced [UK] stroke and heart attack deaths by a minimum of 9,000 per year, with a saving in health care costs of at least £1.5bn a year” (MacGregor and Pombo). Whereas there has been some success over the past decade in reducing the amount of salt consumed, in the Western world the consumption of sugar continues to rise, as a graph cited in the New Scientist indicates (O’Callaghan). Regular warnings that sugar is associated with a range of health threats and delivers empty calories devoid of nutrition have failed to halt the increase in sugar consumption. Further, although some sugar is a natural product, processed foods tend to use a form invented in 1957: high-fructose corn syrup (HFCS). “HFCS is a gloopy solution of glucose and fructose” writes O’Callaghan, adding that it is “as sweet as table sugar but has typically been about 30% cheaper”. She cites Serge Ahmed, a French neuroscientist, as arguing that in a world of food sufficiency people do not need to consume more, so they need to be enticed to overeat by making food more pleasurable. Ahmed was part of a team that ran an experiment with cocaine-addicted rats, offering them a mutually exclusive choice between highly-sweetened water and cocaine: Our findings clearly indicate that intense sweetness can surpass cocaine reward, even in drug-sensitized and -addicted individuals. We speculate that the addictive potential of intense sweetness results from an inborn hypersensitivity to sweet tastants. In most mammals, including rats and humans, sweet receptors evolved in ancestral environments poor in sugars and are thus not adapted to high concentrations of sweet tastants. The supranormal stimulation of these receptors by sugar-rich diets, such as those now widely available in modern societies, would generate a supranormal reward signal in the brain, with the potential to override self-control mechanisms and thus lead to addiction. (Lenoir et al.) The Tongue and the Brain One of the implications of this research about the mammalian desire for sugar is that our taste for food is about more than how these foods actually taste in the mouth on our tongues. It is also about the neural response to the food we eat. The taste of French fries thus also includes that “snap, mouth-feel, and hardness” and the “colloidal fat crystal network” (Rogers, “Novel Structuring” 747). While there is no taste receptor for fats, these nutrients have important effects upon the brain. Wang et al. offered rats a highly fatty, but palatable, diet and allowed them to eat freely. 33 percent of the calories in the food were delivered via fat, compared with 21 percent in a normal diet. The animals almost doubled their usual calorific intake, both because the food had a 37 percent increased calorific content and also because the rats ate 47 percent more than was standard (2786). The research team discovered that in as little as three days the rats “had already lost almost all of their ability to respond to leptin” (Martindale 27). Leptin is a hormone that acts on the brain to communicate feelings of fullness, and is thus important in assisting animals to maintain a healthy body weight. The rats had also become insulin resistant. “Severe resistance to the metabolic effects of both leptin and insulin ensued after just 3 days of overfeeding” (Wang et al. 2786). Fast food restaurants typically offer highly palatable, high fat, high sugar, high salt, calorific foods which can deliver 130 percent of a day’s recommended fat intake, and almost a day’s worth of an adult man’s calories, in one meal. The impacts of maintaining such a diet over a comparatively short time-frame have been recorded in documentaries such as Super Size Me (Spurlock). The after effects of what we widely call “junk food” are also evident in rat studies. Neuroscientist Paul Kenny, who like Ahmed was investigating possible similarities between food- and cocaine-addicted rats, allowed his animals unlimited access to both rat ‘junk food’ and healthy food for rats. He then changed their diets. “The rats with unlimited access to junk food essentially went on a hunger strike. ‘It was as if they had become averse to healthy food’, says Kenny. It took two weeks before the animals began eating as much [healthy food] as those in the control group” (quoted, Trivedi 40). Developing a taste for certain food is consequently about much more than how they taste in the mouth; it constitutes an individual’s response to a mixture of taste, hormonal reactions and physiological changes. Choosing Health Glanz et al. conclude their study by commenting that “campaigns attempting to change people’s perception of the importance of nutrition will be interpreted in terms of existing values and beliefs. A more promising strategy might be to stress the good taste of healthful foods” (1126). Interestingly, this is the strategy already adopted by some health-focused cookbooks. I have 66 cookery books in my kitchen. None of ten books sampled from the five spaces in which these books are kept had ‘taste’ as an index entry, but three books had ‘taste’ in their titles: The Higher Taste, Taste of Life, and The Taste of Health. All three books seek to promote healthy eating, and they all date from the mid-1980s. It might be that taste is not mentioned in cookbook indexes because it is a sine qua non: a focus upon taste is so necessary and fundamental to a cookbook that it goes without saying. Yet, as the physiological evidence makes clear, what we find palatable is highly mutable, varying between people, and capable of changing significantly in comparatively short periods of time. The good news from the research studies is that the changes wrought by high salt, high sugar, high fat diets need not be permanent. Luciano Rossetti, one of the authors on Wang et al’s paper, told Martindale that the physiological changes are reversible, but added a note of caution: “the fatter a person becomes the more resistant they will be to the effects of leptin and the harder it is to reverse those effects” (27). Morgan Spurlock’s experience also indicates this. In his case it took the actor/director 14 months to lose the 11.1 kg (13 percent of his body mass) that he gained in the 30 days of his fast-food-only experiment. Trivedi was more fortunate, stating that, “After two weeks of going cold turkey, I can report I have successfully kicked my ice cream habit” (41). A reader’s letter in response to Trivedi’s article echoes this observation. She writes that “the best way to stop the craving was to switch to a diet of vegetables, seeds, nuts and fruits with a small amount of fish”, adding that “cravings stopped in just a week or two, and the diet was so effective that I no longer crave junk food even when it is in front of me” (Mackeown). Popular culture indicates a range of alternative ways to resist food manufacturers. In the West, there is a growing emphasis on organic farming methods and produce (Guthman), on sl called Urban Agriculture in the inner cities (Mason and Knowd), on farmers’ markets, where consumers can meet the producers of the food they eat (Guthrie et al.), and on the work of advocates of ‘real’ food, such as Jamie Oliver (Warrin). Food and wine festivals promote gourmet tourism along with an emphasis upon the quality of the food consumed, and consumption as a peak experience (Hall and Sharples), while environmental perspectives prompt awareness of ‘food miles’ (Weber and Matthews), fair trade (Getz and Shreck) and of land degradation, animal suffering, and the inequitable use of resources in the creation of the everyday Western diet (Dare, Costello and Green). The burgeoning of these different approaches has helped to stimulate a commensurate growth in relevant disciplinary fields such as Food Studies (Wessell and Brien). One thing that all these new ways of looking at food and taste have in common is that they are options for people who feel they have the right to choose what and when to eat; and to consume the tastes they prefer. This is not true of all groups of people in all countries. Hiding behind the public health campaigns that encourage people to exercise and eat fresh fruit and vegetables are the hidden “social determinants of health: The conditions in which people are born, grow, live, work and age, including the health system” (WHO 45). As the definitions explain, it is the “social determinants of health [that] are mostly responsible for health iniquities” with evidence from all countries around the world demonstrating that “in general, the lower an individual’s socioeconomic position, the worse his or her health” (WHO 45). For the comparatively disadvantaged, it may not be the taste of fast food that attracts them but the combination of price and convenience. If there is no ready access to cooking facilities, or safe food storage, or if a caregiver is simply too time-poor to plan and prepare meals for a family, junk food becomes a sensible choice and its palatability an added bonus. For those with the education, desire, and opportunity to break free of the taste for salty and sugary fats, however, there are a range of strategies to achieve this. There is a persuasive array of evidence that embracing a plant-based diet confers a multitude of health benefits for the individual, for the planet and for the animals whose lives and welfare would otherwise be sacrificed to feed us (Green, Costello and Dare). Such a choice does involve losing the taste for foods which make up the lion’s share of the Western diet, but any sense of deprivation only lasts for a short time. The fact is that our sense of taste responds to the stimuli offered. It may be that, notwithstanding the desires of Jamie Oliver and the like, a particular child never will never get to like broccoli, but it is also the case that broccoli tastes differently to me, seven years after becoming a vegan, than it ever did in the years in which I was omnivorous. When people tell me that they would love to adopt a plant-based diet but could not possibly give up cheese, it is difficult to reassure them that the pleasure they get now from that specific cocktail of salty fats will be more than compensated for by the sheer exhilaration of eating crisp, fresh fruits and vegetables in the future. Conclusion For decades, the mass market food industry has tweaked their products to make them hyper-palatable and difficult to resist. They do this through marketing experiments and consumer behaviour research, schooling taste buds and brains to anticipate and relish specific cocktails of sweet fats (cakes, biscuits, chocolate, ice cream) and salty fats (chips, hamburgers, cheese, salted nuts). They add ingredients to make these products stimulate taste buds more effectively, while also producing cheaper items with longer life on the shelves, reducing spoilage and the complexity of storage for retailers. Consumers are trained to like the tastes of these foods. Bitter, sour, and umami receptors are comparatively under-stimulated, with sweet, salty, and fat-based tastes favoured in their place. Western societies pay the price for this learned preference in high blood pressure, high cholesterol, diabetes, and obesity. Public health advocate Bruce Neal and colleagues, working to reduce added salt in processed foods, note that the food and manufacturing industries can now provide most of the calories that the world needs to survive. “The challenge now”, they argue, “is to have these same industries provide foods that support long and healthy adult lives. And in this regard there remains a very considerable way to go”. If the public were to believe that their sense of taste is mutable and has been distorted for corporate and industrial gain, and if they were to demand greater access to natural foods in their unprocessed state, then that journey towards a healthier future might be far less protracted than these and many other researchers seem to believe. References Bernstein, Adam, and Walter Willett. “Trends in 24-Hr Sodium Excretion in the United States, 1957–2003: A Systematic Review.” American Journal of Clinical Nutrition 92 (2010): 1172–1180. Bhaktivedanta Book Trust. 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