Healthcare burden and reimbursement of hospitalization during chemotherapy for adults with Ph-negative relapsed or refractory B-cell precursor acute lymphoblastic leukemia in France: a retrospective chart review

Objective: Philadelphia chromosome negative [Ph(?)] relapsed or refractory (R/R) B-precursor acute lymphoblastic leukemia (ALL) is an extremely rare condition requiring intensive treatment. This retrospective chart review aimed to quantify hospitalizations and reimbursement in this patient population in France.

Methods: Patients aged ≥18 years and with at least one hospitalization for Ph(?) R/R B-precursor ALL were included in the study. They were relapsed with first remission lasting <12 months, relapsed after first salvage therapy, relapsed any time after hematopoietic stem cell transplant (HSCT), or were refractory to initial or salvage therapy. Data were collected from the index date (first diagnosis of R/R ALL) until death or loss to follow-up. The chemotherapy period was defined as the first chemotherapy date after the index date to the earliest of death, loss to follow-up, last chemotherapy dose plus 30 days, or initiation of HSCT. The primary outcome was the percentage of time hospitalized during the chemotherapy period.

Results: Thirty-three patients were included, with a mean age of 49 years. The mean proportion of time spent in the hospital during the chemotherapy period was 46% (95% CI =34–57%). Patients had a mean of 2.2 (SD =1.5) inpatient hospitalizations and the mean length of stay per hospitalization was 16.8 (SD =14.8) days. During the chemotherapy period, the mean amount reimbursed per hospitalization was €31 067 (SD = €4850) and the total hospitalization reimbursement per patient was €68 344. From the index date to death, excluding HSCT, the total reimbursement per patient was €108 873.

Limitations: The sample size was small, although this was expected given the rarity of the patient population.

Conclusions: Adults with Ph(?) R/R B-precursor ALL had repeated and prolonged hospitalizations during salvage chemotherapy. Approximately half the follow-up period was spent in the hospital, and this time was associated with high economic burden in France.     

The Myth of Fair Prices: A Graphical Analysis

The issues of fair trade and in particular fair price policies, have been neglected in most international trade courses. The authors show how the latter can be explained to undergraduate students applying the simple graphical methods normally used in general equilibrium trade theory. They show that fair pricing strategies can be looked upon as a suboptimal device for redistributing the gains from trade as compared with a transfer of funds.     

Experienced versus decision utility: large-scale comparison for income–leisure preferences*

Subjective well-being (SWB) data are increasingly used to perform welfare analysis. Interpreted as “experienced utility”, it has recently been compared to “decision utility” using small-scale experiments most often based on stated preferences. We transpose this comparison to the framework of non-experimental and large-scale data commonly used for policy analysis, focusing on the income–leisure domain where redistributive policies operate. Using the British Household Panel Survey, we suggest a “deviation” measure, which is simply the difference between actual working hours and SWB-maximizing hours. We show that about three-quarters of individuals make decisions that are not inconsistent with maximizing their SWB. We discuss the potential channels that explain the lack of optimization when deviations are significantly large. We find proxies for a number of individual and external constraints, and show that constraints alone can explain more than half of the deviations. In our context, deviations partly reflect the inability of the revealed preference approach to account for labor market rigidities, so the actual and SWB-maximizing hours should be used in a complementary manner. The suggested approach based on our deviation metric could help identify labor market frictions.     

Volatilidad en los ingresos y en el mercado de trabajo de los jóvenes en Europa

Los autores ofrecen nuevos datos empíricos sobre la volatilidad en los ingresos y en el mercado de trabajo (incluyendo entradas y salidas del empleo) de los jóvenes en Europa durante la Gran Recesión. Los datos de EU‐SILC para el periodo 2004–2013 revelan grandes disparidades al respecto entre los países europeos. La Gran Recesión incrementó la volatilidad entre los jóvenes. Mediante un ejercicio de descomposición de la varianza se observa una mayor rotación laboral en el sur de Europa. Según un modelo de efectos fijos, un mayor nivel de prestaciones de desempleo y de protección del empleo se asocia con una reducción de la volatilidad.     

Service-Oriented Computing for intelligent train maintenance

The purpose of this work is to apply the servicization of enterprise information systems in maintenance, particularly in the management of the maintenance process of the component parts of trains. Service Oriented Architecture (SOA) is an architectural approach that permits servicization since it provides a flexible set of design principles used during the modeling practices (abstraction and realization). With a view to supporting the model-driven engineering of software systems, Mode Driven Architecture (MDA) is a design approach delivering a set of guidelines for the configuring of specifications in systems development. Therefore, the combination of these two approaches can be fruitful to address the challenging issues the enterprise information system is facing today. Our study is based on a methodological approach using the MDA models for the automatic generation of web service. The case study concerns a Railways Maintenance Workshop (RMW) at Sidi Bel Abbes (Algeria). Finally, the information system for the management of maintenance of the component parts of passengers and baggage railcars, using the generated solution, is realized and deployed. This software helps to have better management of the RMW by the effective planning of interventions, improve performance by increasing reliability, traceability, and availability of the equipment (parts).     

Partner‐diversity effects on alliance termination in the early stage of green alliance formation: Empirical evidence from carbon‐emission reduction projects in Latin America

Partner diversity is a key influencer in interorganizational alliances, and several empirical studies have shown that its outcomes are contingent on alliance‐specific factors. We extend this research as well as the growing literature on green alliances, in which partner diversity is uniquely high. Specifically, we examine partner‐diversity effects on alliance termination in the early stage of green alliance formation. We hypothesize that in this context, size disparity increases termination likelihood, whereas organizational variety and cultural separation have the opposite effect. To test our hypotheses, we use a sample of 366 alliance projects located in Latin America and submitted to the Kyoto Protocol's Clean Development Mechanism for evaluation, validation, and registration from 2004 to 2014. Our findings contribute to several research streams and provide practical guidance for successful formation of alliances focused on environmental protection.     

Disruptive technology adoption,particularities of clustered firms

ABSTRACT

This article explores to what extent the internal attributes of a clustered firm influence its capacity to adopt disruptive innovations. A multidimensional approach to the absorptive capacity (ACAP) model is used to distinguish between potential (acquisition and assimilation domains) and realized (transformation and exploitation domains) internal firm capabilities. Our evidence comes from an empirical analysis of the population of firms belonging to the Spanish ceramic tile cluster which have adopted a disruptive innovation – the so-called digital printing technology – on a massive scale. The econometric estimations suggest the relevance of the Exploitation dimension of ACAP for early adoption of a new technology. In contrast, the other dimensions do not seem to play a decisive role when it comes to adopting one novelty earlier than others. In conclusion, and contrary to what was expected for non-clustered firms, the results revealed an uneven effect of the potential and realized domains of ACAP of clustered firms regarding the rate of adoption of distant technologies.     

Horizontal Inequity and Vertical Redistribution

Inequality of post-tax income among pre-tax equals is evaluated andaggregated to form a global index of horizontal inequity in the income tax.The vertical action of the tax is captured by its inequality effect on averagebetween groups of pre-tax equals. Putting the two together, horizontalinequity measures loss of vertical performance. The identification problem,which has previously been thought insuperable, is addressed by a procedurevalidating the banding of income units into close equals groups. Thehorizontal and vertical effects of a major Spanish income tax reform areevaluated. Lines for future investigation are suggested.