Major bleeding risk and healthcare economic outcomes of non-valvular atrial fibrillation patients newly-initiated with oral anticoagulant therapy in the real-world setting

Aims: This study compared the risk for major bleeding (MB) and healthcare economic outcomes of patients with non-valvular atrial fibrillation (NVAF) after initiating treatment with apixaban vs rivaroxaban, dabigatran, or warfarin.

Methods: NVAF patients who initiated apixaban, rivaroxaban, dabigatran, or warfarin were identified from the IMS Pharmetrics Plus database (January 1, 2013–September 30, 2015). Propensity score matching (PSM) was used to balance differences in patient characteristics between study cohorts: patients treated with apixaban vs rivaroxaban, apixaban vs dabigatran, and apixaban vs warfarin. Risk of hospitalization and healthcare costs (all-cause and MB-related) were compared between matched cohorts during the follow-up.

Results: During the follow-up, risks for all-cause (hazard ratio [HR]?=?1.44, 95% confidence interval [CI]?=?1.2–1.7) and MB-related (HR?=?1.57, 95% CI?=?1.0–2.4) hospitalizations were significantly greater for patients treated with rivaroxaban vs apixaban. Adjusted total all-cause healthcare costs were significantly lower for patients treated with apixaban vs rivaroxaban ($3,950 vs $4,333 per patient per month [PPPM], p?=?.002) and MB-related medical costs were not statistically significantly different ($100 vs $233 PPPM, p?=?.096). Risk for all-cause hospitalization (HR?=?1.98, 95% CI?=?1.6–2.4) was significantly greater for patients treated with dabigatran vs apixaban, although total all-cause healthcare costs were not statistically different. Risks for all-cause (HR?=?2.22, 95% CI?=?1.9–2.5) and MB-related (HR?=?2.05, 95% CI?=?1.4–3.0) hospitalizations were significantly greater for patients treated with warfarin vs apixaban. Total all-cause healthcare costs ($3,919 vs $4,177 PPPM, p?=?.025) and MB-related medical costs ($96 vs $212 PPPM, p?=?.026) were significantly lower for patients treated with apixaban vs warfarin.

Limitations: This retrospective database analysis does not establish causation.

Conclusions: In the real-world setting, compared with rivaroxaban and warfarin, apixaban is associated with reduced risk of hospitalization and lower healthcare costs. Compared with dabigatran, apixaban is associated with lower risk of hospitalizations.     

An empirical analysis of green convention attendees' switching intentions

This study aims at proposing to test a research model to gain a better understanding of the relationships among the dimensions of experiential quality, green experiential satisfaction, green alternative attractiveness, green service fairness, green variety-seeking, and green switching intentions. The study's findings are based on structural equation model analysis of a convenience sample of 650 attendees at the 13th International Green Building and Energy-Savings Exhibition 2016 in Chongqing, China. The results of this analysis contribute to the services marketing theory by providing additional insights into green switching intentions, the dimensions of experiential quality, green experiential satisfaction, green alternative attractiveness, green service fairness, and green novelty-seeking. The study's results will assist green convention management in developing and implementing market-orientated service strategies to increase the dimensions of experiential quality and green experiential satisfaction, enhance green alternative attractiveness, green service fairness, and green novelty-seeking, and decrease green switching intentions.     

Non-linear dynamics in international resource markets: Evidence from regime switching approach

This paper examines the nonstationary and nonlinear features of the non-renewable resource markets: the crude oil (US West Texas Intermediate and UK Brent), bituminous coal and natural gas markets. In particular, we achieve this goal by using the Markov switching unit root regression. This approach is attractive because it allows price to switch between stationary and nonstationary regimes (partial nonstationarity). It also allows price to switch between two stationary regimes (varied stationarity) or to switch between two nonstationary regimes (varied nonstationarity). The results of a range of non-linear tests show that the independently and identically distributed (i.i.d.) hypothesis or the random walk hypothesis is untenable for the non-renewable resource prices. The results from the Markov regression indicate that, in the cases of US West Texas Intermediate, UK Brent as well as bituminous coal, prices are characterized by the local nonstationarity in both regimes, and therefore varied nonstationarity is sustained. The price of natural gas is characterized by partial nonstationarity, indicating that this market is inconsistent with the efficient market.     

An options pricing approach to ramping rate restrictions at hydro power plants

This paper investigates the impact of ramping rate restrictions imposed on hydro operations to protect aquatic ecosystems. The optimal ramping decision is specified as an optimal control problem which results in a Hamilton Jacobi Bellman (HJB) equation. Electricity prices are modelled as a regime switching stochastic process. The optimal control is determined by solving the HJB equation numerically using a fully implicit finite difference approach with semi-Lagrangian time stepping. The paper focuses on the effect of ramping restrictions on a hydro plant׳s value and optimal operations, and provides an analysis of which factors cause ramping restrictions to have a greater or lesser impact on profitability. It is shown that hydro plant value is negatively affected by ramping restrictions, but the extent of the impact depends on key parameters which determine the desirability of frequent changes in water release rates. Interestingly for the case considered, value is not sensitive to ramping restrictions over a large range of restrictions. The results point to the importance of accurately modelling electricity prices in gauging the trade offs involved in imposing restrictions on hydro operators which may hinder their ability to respond to volatile electricity prices and meet peak demands.     

Leading national brands facing store brands competition: Is price competitiveness the only thing that matters?

Store Brands (SBs) have experienced a strong increase in both value and unit sales internationally during the last decades; thus their market share has been constantly growing. Starting from these considerations, the present work aims at deepening the topic of inter-brand competition within the FMCG market and, in particular, the market share trade-off between Leading National Brands (LNBs) and Store Brands. Our empirical analysis is based on panel data about 322 product categories sold within the Modern Grocery Distribution stores in the 2010–2013 period. Results obtained show: (i) the existence of a relationship between the increase in the LNB-SB price gap and the switching of market share from the former towards the latter; (ii) the consolidation of a change in consumers' purchasing preference in favor of SBs; (iii) the existence of an inverse relationship between the inter-brand competition intensity and the retail branding life cycle evolutionary stage, which is different for each product category.     

Shipping route choice across geographies: Coastal vs. landlocked countries

This paper investigates how geography and transportation costs influence the decisions by shippers of which port of export to use. Using a large sample of disaggregated shipments originating from several countries in Europe, we show that European logistics networks exhibit a low level of international integration that affects shipping route choice. Furthermore, we find significant differences in shipping behaviors across landlocked and coastal countries, with shippers in landlocked countries avoiding long land transportation, crossing borders readily, and placing more value on transportation infrastructure. These findings have implications in designing port competitiveness strategies and economic development policies in landlocked countries.     

Factors influencing theme park visitor brand-switching behaviour as based on visitor perception

With the development of theme parks, which represent a multi-million-pound industry worldwide, research investigating the factors affecting theme park visitor brand-switching behaviour is an important method for improving theme park competitiveness. In the present work, models and research hypothesis are constructed based on visitor perception, and the survey data are collected and analysed to assess the hypothesis and to revise the conceptual model in this paper. The results indicate that there are seven factors influencing visitor brand-switching behaviour: ‘visitor variety-seeking', ‘visitor satisfaction', ‘switching cost', ‘perceived value', ‘competitor attraction', ‘theme park image' and ‘visitor involvement'. The perceived value and visitor satisfaction strongly influence brand-switching behaviour as intermediate variables. Visitor variety-seeking and competitor attraction are positively related to visitor brand switching behaviour, whereas the other five factors are negatively related to visitor brand-switching behaviour.     

Designing intergovernmental fiscal transfers for conservation: The case of REDD+ revenue distribution to local governments in Indonesia

A REDD+ scheme would involve the transfer of financial resources to forested developing countries taking part in it. This paper simulates different approaches to the design of intergovernmental fiscal transfers (IFTs), a possible means to channel a REDD+ international payment to local governments which, in several countries, have a certain degree of authority over forest management. Using Indonesia as a case study, the cost-reimbursement and the derivation approaches are tested. It is demonstrated that both approaches could be used. Using the cost-reimbursement approach, localities with more degraded forests would receive a higher compensation per unit of carbon emission reduction than districts with primary forests. Avoiding further conversion of logged-over areas is associated with higher opportunity costs when compared with preventing the conversion of primary forests. In contrast, the derivation approach sets a fixed percentage and rate to distribute REDD+ revenues and ignores the opportunity costs of REDD+ incurred by local governments. The distribution of REDD+ revenues to eligible local governments is based on an assumed market price of carbon credits from REDD+. This paper concludes by discussing the implications of the findings for designing the distribution of REDD+ revenues, both for Indonesia and more generically for other developing countries.     

THE THEORY OF ENDOGENOUS MARKET STRUCTURES

Most market structures are neither perfectly or monopolistically competitive: they are characterized by a few large firms that are engaged in strategic interactions in their production and investment decisions and whose number is endogenous. The theory of endogenous market structures analyzes markets in partial and general equilibrium where strategies affect entry and entry affects strategies, and exogenous primitive conditions on technology and preferences affect the equilibrium. We discuss applications to industrial organization, international trade, business cycle theory, international finance, growth and implications for welfare and for competition, trade, fiscal and monetary policy.     

Entry,trade costs,and international business cycles

Are firm entry and fixed exporting costs relevant for understanding the international transmission of business cycles? We revisit this question using a model that includes entry, selection to exporting activity, physical capital accumulation and endogenous labor supply. We determine that once the stochastic process for exogenous productivity is calibrated to consider the endogenous dynamics in TFP created by the number of firms and the time series volatility of entry is calibrated to the data, our model yields minimal departures from the Backus et al. (1992) benchmark. The richer model shares all of the successes of the previous model in terms of the volatilities of aggregate quantities, as well as its failures, in terms of replicating patterns of international co-movement and the volatility of international relative prices.