Repositioning the urban environment question in Zimbabwe: a review of the context,conditions and processes

This analysis is a reappraisal of two perspectives in urban development in Zimbabwe: environmental sustainability and human sustenance. The discussion seeks to reposition the conservation–survival debate by broadening it to the wider urban and national macroeconomic and sociopolitical context. It re‐examines Zimbabwe's environmental problems by examining the challenges posed by urbanisation, industrialisation and informalisation. To these ‘permanent’ strands are added the ‘transient’ phenomena of structural adjustment and indigenisation. The analysis is done within the overall national macroeconomic and sociopolitical environment. The article examines environmental sustainability and human sustenance as the two policy challenges that have to be reconciled in the quest for sustainable urban settlements in Zimbabwe. The analysis stresses that the exercise of striking a balance between the needs of humankind and those of nature has to take cognisance of the complexity of issues and the processes going on elsewhere in the urban and national context.     

Biotechnology: the emerging battlefield for US and Japanese pharmaceutical companies

The Japanese pharmaceutical industry has lagged behind the US in developing and marhting innovative new compounh. A gap anabsis rebing on international publication and patenting stahtics as well as market survgs shows that the US is the clear leader in biophannaceuticals. Recent Japanese public and private efforts to close the gap have posed no immediate threat to US pharmaceutical companies. The conflict over industrial policy among the ministries involved will take some time to be resolved. However, information networking activities and cross-border technology linkages of Japanese companies should not be underestimated. Biotechnology is current4 transforming theJapanese pharmaceutical induse, and the US will have to deal with a gowing Japanese challenge in the long run. Preventive US counter-measures should include investments in in-house biotechnology research, acquisitions of smaller biotechnology start-up ventures, global commercialization o f biophannaceuticals, and proactive management o f technology linkages with Japanese companies.     

Evaluation of medical costs associated with use of new oral anticoagulants compared with standard therapy among venous thromboembolism patients

Objective:

This study evaluated differences in medical costs associated with clinical end-points from randomized clinical trials that compared the new oral anticoagulants (NOACs), dabigatran, rivaroxaban, apixaban, and edoxaban, to standard therapy for treatment of patients with venous thromboembolism (VTE).

Research design and methods:

Event rates of efficacy and safety end-points from the clinical trials (RE-COVER, RE-COVER II, EINSTEIN-Pooled, AMPLIFY, Hokusai-VTE trial) were obtained from published literature. Incremental annual medical costs among patients with clinical events from a US payer perspective were obtained from the literature or healthcare claims databases and inflation adjusted to 2013 costs. Differences in total medical costs associated with clinical end-points for the NOACs vs standard therapy were then estimated. One-way and Monte Carlo sensitivity analyses were carried out.

Results:

A lower rate of major bleedings was associated with use of any of the NOACs vs standard therapy. Except for dabigatran, use of NOACs was also associated with a lower rate of recurrent VTE/death. As a result of the reduction in clinical event rates, the overall medical cost differences were ?$146, ?$482, ?$918, and ?$344 for VTE patients treated with dabigatran, rivaroxaban, apixaban, and edoxaban, respectively, vs patients treated with standard therapy.

Conclusions:

When any of the four NOACs are used instead of standard therapy for acute VTE, treatment medical costs are reduced. Apixaban is associated with the greatest reduction in medical costs, which is driven by medical cost reductions associated with both efficacy and safety end-points. Further evaluation may be needed to validate these results in the real-world setting.     

A near Pareto optimal auction with budget constraints

In a setup where a divisible good is to be allocated to a set of bidders with budget constraints, we introduce a mechanism in the spirit of the Vickrey auction. In the mechanism we propose, understating budgets or values is weakly dominated. Since the revenue is increasing in budgets and values, all kinds of equilibrium deviations from true valuations turn out to be beneficial to the auctioneer. We also show that ex-post Nash equilibrium of our mechanism is near Pareto optimal in the sense that all full winners? values are above all full losers? values.     

‘Gay Enclaves Face Prospect of Being PassÉ': How Assimilation Affects the Spatial Expressions of Sexuality in the United States

Journalists, activists and academics alike predict that gay neighborhoods in the United States will disappear, yet many of their claims are unsubstantiated or overly determined by economic factors. This article examines 40 years of media accounts to identify the mechanisms that explain why these urban areas are changing. I begin with the observation that the rate of assimilation of sexual minorities into mainstream society has accelerated in today's so‐called ‘post‐gay' era. Assimilation expands the residential imagination of gays and lesbians beyond the boundaries of a specific neighborhood to the entire city itself. Furthermore, as sexual orientation recedes in centrality in everyday life, residents opine that few care if a person self‐identifies as gay or straight. These two respective mechanisms of expansion and cultural sameness bring existing economic wisdom into dialogue with a cultural and political perspective about how our shifting understandings of sexuality also affect the decisions we make about where to live and socialize.     

城市创新文化建设的国际比较分析

以东京、巴塞罗那和曼彻斯特三个典型的创新型城市为对象,从环境条件(可视层)、制度行为(制度层)和价值理念(精神层)三个层面对其城市创新文化建设进行了比较分析。得出对我国创新型城市创新文化建设的启示:从传统文化中汲取养分,倡导创新观念、营造创新氛围;规划文化发展,整合创新资源,培养、引进各类优秀人才;完善创新机制,激发创新活力。     

Real-world comparison of all-cause hospitalizations,hospitalizations due to stroke and major bleeding,and costs for non-valvular atrial fibrillation patients prescribed oral anticoagulants in a US health plan

Aims: To compare the risk of all-cause hospitalization and hospitalizations due to stroke/systemic embolism (SE) and major bleeding, as well as associated healthcare costs for non-valvular atrial fibrillation (NVAF) patients initiating apixaban, dabigatran, rivaroxaban, or warfarin.

Materials and methods: NVAF patients initiating apixaban, dabigatran, rivaroxaban, or warfarin were selected from the OptumInsight Research Database from January 1, 2013–September 30, 2015. Propensity score matching (PSM) was performed between apixaban and each oral anticoagulant. Cox models were used to estimate the risk of stroke/SE and major bleeding. Generalized linear and 2-part models were used to compare healthcare costs.

Results: Of the 47,634 eligible patients, 8,328 warfarin-apixaban pairs, 3,557 dabigatran-apixaban pairs, and 8,440 rivaroxaban-apixaban pairs were matched. Compared to apixaban, warfarin patients were associated with a significantly higher risk of all-cause (hazard ratio [HR]?=?1.30; 95% confidence interval [CI]?=?1.21–1.40) as well as stroke/SE-related (HR?=?1.60; 95% CI?=?1.23–2.07) and major bleeding-related (HR?=?1.95; 95% CI?=?1.60–2.39) hospitalization; rivaroxaban patients were associated with a higher risk of all-cause (HR?=?1.15; 95% CI?=?1.07–1.24) and major bleeding-related hospitalization (HR?=?1.71; 95% CI?=?1.39–2.10); and dabigatran patients were associated with a higher risk of major bleeding hospitalization (HR?=?1.46, 95% CI?=?1.02–2.10). Warfarin patients had significantly higher major bleeding-related and total all-cause healthcare costs compared to apixaban patients. Rivaroxaban patients had significantly higher major bleeding-related costs compared to apixaban patients. No significant results were found for the remaining comparisons.

Limitations: No causal relationships can be concluded, and unobserved confounders may exist in this retrospective database analysis.

Conclusions: This study demonstrated a significantly higher risk of hospitalization (all-cause, stroke/SE, and major bleeding) associated with warfarin, a significantly higher risk of major bleeding hospitalization associated with dabigatran or rivaroxaban, and a significantly higher risk of all-cause hospitalization associated with rivaroxaban compared to apixaban. Lower major bleeding-related costs were observed for apixaban patients compared to warfarin and rivaroxaban patients.     

A practical road map for assessing cyber risk

The increase in interconnectivity and developments in technology have caused cyber security to become a universal concern. This paper highlights the dangers of the evolution of cyber risk, the challenges of quantifying the impact of cyber-attacks and the feasibility of the traditional actuarial methodologies for quantifying cyber losses. In this paper, we present a practical roadmap for assessing cyber risk, a roadmap that emphasizes the importance of developing a company and culture-specific risk and resilience model. We develop a structure for a Bayesian network to model the financial loss as a function of the key drivers of risk and resilience. We use qualitative scorecard assessment to determine the level of cyber risk exposure and evaluate the effectiveness of resilience efforts in the organization. We highlight the importance of capitalizing on the knowledge of experts within the organization and discuss methods for aggregating multiple assessments. From an enterprise risk management perspective, impact on value should be the primary concern of managers. This paper uses a value-centric/reputational approach to risk management rather than a regulatory/capital-centric approach to risk.     

Bayesian and Bühlmann credibility for phase-type distributions with a univariate risk parameter

Credibility theory is a statistical tool to calculate the premium for the next period based on past claims experience and the manual rate. Each contract is characterized by a risk parameter. A phase-type (or PH) random variable, which is defined as the time until absorption in a continuous-time Markov chain, is fully characterized by two sets of parameters from that Markov chain: the initial probability vector and transition intensity matrix. In this article, we identify an interpretable univariate risk parameter from amongst the many candidate parameters, by means of uniformization. The resulting density form is then expressed as an infinite mixture of Erlang distributions. These results are used to obtain a tractable likelihood function by a recursive formula. Then the best estimator for the next premium, i.e. the Bayesian premium, as well as its approximation by the Bühlmann credibility premium are calculated. Finally, actuarial calculations for the Bühlmann and Bayesian premiums are investigated in the context of a gamma prior, and illustrated by simulated data in a series of examples.