Gastric liposarcoma: CT appearance

Two cases of liposarcoma of the stomach are described. At computed tomography (CT) the neoplasms showed features of an aggressive malignant tumor, with no fatty values within. We discuss the differential diagnosis of such lesions and conclude that, although rare, liposarcoma should be considered as a possible diagnosis when a large exophytic gastric mass is detected at CT.     

Organizational Learning: Debates Past, Present And Future

In this paper we attempt to map the development of organizational learning as a field of academic study by examining the rise and fall of specific debates. This does not pretend to be a comprehensive review of the field since there is now far too much material available to allow full coverage in any single publication. Rather, we have identified some of the key debates, and these have been organized along the simplistic time-line of past, present and future. Our purpose is two-fold: first, to note how the nature and language of the key ideas in organizational learning have changed over time; and second, to locate the papers in this Special Issue within the context of the developing field. It is perhaps no accident that we see most of the papers as closely associated with new, and emerging, issues, but we also find it interesting to note that many of these current or emergent issues actually have roots within some of the earlier debates.     

Cost-effectiveness of metformin plus vildagliptin compared with metformin plus sulphonylurea for the treatment of patients with type 2 diabetes mellitus: a Portuguese healthcare system perspective

Objective:

To evaluate the cost-effectiveness of vildagliptin plus metformin vs generic sulphonylurea plus metformin in patients with type 2 diabetes mellitus, not controlled with metformin, from a Portuguese healthcare system perspective.

Methods:

A cost-effectiveness model was constructed using risk equations from the UK Prospective Diabetes Study Outcomes Model with a 10,000-patient cohort and a lifetime horizon. The model predicted microvascular and macrovascular complications and mortality in yearly cycles. Patients entered the model as metformin monotherapy failures and switched to alternative treatments (metformin plus basal-bolus insulin and subsequently metformin plus intensive insulin) when glycated hemoglobin A1c >7.5% was reached. Baseline patient characteristics and clinical variables were derived from a Portuguese epidemiological study. Cost estimates were based on direct medical costs only. One-way and probabilistic sensitivity analyses were conducted to test the robustness of the model.

Results:

There were fewer non-fatal diabetes-related adverse events (AEs) in patients treated with metformin plus vildagliptin compared with patients treated with metformin plus sulphonylurea (6752 vs 6815). Addition of vildagliptin compared with sulphonylurea led to increased drug acquisition costs but reduced costs of AEs, managing morbidities, and monitoring patients. Treatment with metformin plus vildagliptin yielded a mean per-patient gain of 0.1279 quality-adjusted life years (QALYs) and a mean per-patient increase in total cost of €1161, giving an incremental cost-effectiveness ratio (ICER) of €9072 per QALY. Univariate analyses showed that ICER values were robust and ranged from €4195 to €16,052 per QALY when different parameters were varied.

Limitations:

The model excluded several diabetes-related morbidities, such as peripheral neuropathy and ulceration, and did not model second events. Patients were presumed to enter the model with no diabetes-related complications.

Conclusion:

Treatment with metformin plus vildagliptin compared with metformin plus sulphonylurea is expected to result in a lower incidence of diabetes-related AEs and to be a cost-effective treatment strategy.     

Transformational Growth in the 1990s: Government,Finance and High-tech

Our aim is to understand how the process of transformational growth during the 1990s shaped the boom and bust of the New Economy. From the debate on new technologies and productivity growth, we move on to consider the questions raised by technological developments of the 1990s. Our focus is on the three-way relationship between the development of information and communications technologies, structural change and economic growth, as the key determinants of the cycle of expansion. This brings to the fore the effects of private investment driven by high-technology but we also need to consider the role played by finance and macro policy, and, in particular, the government budget.     

Growth,Normal Capacity Utilization and the Long-Run Saving Ratio: A Comment

In a recent paper Attilio Trezzini presents an explanation of the saving ratio that does not rely on normal capacity utilization positions. Trezzini instead focuses on the fluctuations of consumption and investment. But that very focus, I argue, requires a different kind of approach. Once the traditional theory of saving is discarded, the ‘indeterminacy’ of the saving ratio opens the way to an analysis of the evolution of consumption, and of how that evolution affects aggregate demand. The generation and evolution of autonomous demand are matters of obvious relevance to the classical Keynesian approach to the analysis of growth. The present comment takes James Duesenberry’s criticism of demand theory as the starting point for an examination of the evolving standard of consumption and autonomous (‘innovative’) investment, therefore addressing directly the investment–consumption relationship. There are of course a number of complicated questions involved and they have not yet been satisfactorily analysed. They are part of the necessary task of articulating a theory of consumption consistent with demand-led growth and forward-looking investment decisions.     

Fare elasticities of demand for direct and indirect flights in sub-Saharan Africa

This article examines the different demands for direct and indirect flights within sub-Saharan Africa. It develops both a simple reduced form model and a more refined two equation simultaneously system to examine bookings and fares on the major air transportation corridors. Using panel data, this allows estimation of the different fare elasticities of demand for direct and indirect services between the continents’ major cities as well as assessing the respective merits of the two models used.     

Are regional systems greening the economy? Local spillovers,green innovations and firms’ economic performances

The adoption and diffusion of environmental innovations (EIs) is crucial to greening the economy and achieving win–win environmental/economic gains. A large and increasing literature has focused on the levers underlying EIs that are external to the firm, such as stakeholder and policy pressures. Little attention, however, has been devoted to the possible role of local spillovers of a sector/geographical nature as a factor that correlates with EIs and economic performances. A rich data set that covers the innovative activities and economic performances of firms in the Emilia-Romagna region in Italy, an area dense in manufacturing districts, is analysed. EIs’ drivers and effects on firms’ performance are investigated through a two-step procedure. First, we examine the relevance of spatial levers, namely, whether high rates of eco-innovators in a given local area induce the adoption of EIs in firms located in the same local area. The role of the ‘agglomeration lever’ turns out to be fairly local in nature: we find that spillovers are significantly inducing innovation within municipal boundaries. Second, we test whether EIs adoptions have significantly increased firms’ economic performances and find that some firms’ productivity performances are positively related to EI adoption.     

The Transfer Problem in the Euro Area

Building on the celebrated Keynes–Ohlin debate and on Lane and Milesi-Ferretti (Rev Econ Stat 86:841–857, 2004), the paper investigates the transfer problem for the Euro area vis-à-vis the rest of the world. The analysis is developed in a theoretically and statistically consistent way and is intended as a contribution to the empirical literature on EMU. The main result of the paper is that the accumulation of net foreign asset in the Euro area is consistent with real exchange appreciation, largely through the relative price of nontradables rather than through the terms of trade.

Interregional Migration of Human Capital and Unemployment Dynamics: Evidence from Italian Provinces

Since the mid‐1990s interregional migration flows in Italy have dramatically increased, especially from the South to the North. These flows are characterized by a strong component of human capital, involving a large number of workers with secondary and tertiary education. Using longitudinal data for the period 2002–2011 at NUTS‐3 territorial level, we document that long‐distance (i.e., South‐North) net migration of high‐skill workers has increased the unemployment at origin and decreased it at destination, thus deepening North–South unemployment disparities. On the other hand, long‐distance net migration of low‐skill workers has had the opposite effect, by lowering the unemployment at origin and raising it at destination. Further evidence also suggests that the diverging effect of high‐skill migration dominates the converging effect of low‐skill migration. Thus, concerns for an ‘internal brain drain’ from Southern regions look not groundless.