Economic modelling of costs associated with outcomes reported for type 2 diabetes mellitus (T2DM) patients in the CANVAS and EMPA-REG cardiovascular outcomes trials

Aims: To model direct medical costs associated with reductions in cardiovascular disease (CVD) events in T2DM patients reported in the CANVAS and EMPA-REG trials, which assessed the cardiovascular safety of canagliflozin and empagliflozin, respectively.

Materials and methods: Costs were modeled from a US managed care organization (MCO) perspective for the CVD outcomes included in both trials: three-point major adverse cardiovascular event (MACE) and its components (cardiovascular-related death, nonfatal myocardial infarction, nonfatal stroke), as well as heart failure requiring hospitalization. The rate of CVD events averted (difference between study drug and placebo) was projected to the portion of an MCO T2DM population matching the respective trial’s inclusion criteria. A targeted literature search for paid amounts directly associated with each CVD event provided the unit costs, which were applied to the projected number of events averted, to calculate costs avoided per member per year (PMPY). One-way sensitivity analyses were performed on events averted, unit costs, and percentages of trial-applicable patients.

Results: Based on three-point MACE events averted, costs avoided PMPY of $6.17 (range: $1.27–$10.94) for CANVAS and $2.75 ($0.19–$4.83) for EMPA-REG were estimated. Costs avoided for individual components of MACE ranged from $0.77 to $3.84 PMPY for CANVAS and from -$0.97 (additional costs) to $1.54 for EMPA-REG. PMPY costs avoided for heart failure were $2.72 for CANVAS and $1.32 for EMPA-REG.

Limitations and conclusions: Models assumed independent, non-recurrent outcomes and were restricted to medical costs directly associated with the trial-reported events. The reductions in CVD events in T2DM patients reported for both CANVAS and EMPA-REG project to a positive cost avoidance for these events in an MCO population. The analysis did not include an assessment of the impact on total cost, as the costs associated with adverse events, drug utilization or other clinical outcomes were not examined.     

Stock market reactions to monetary policy surprises under uncertainty

This article investigates how uncertainty impacts the effect of monetary policy surprises on stock returns. Using high-frequency US data, we demonstrate that stock markets respond more aggressively to monetary policy surprises during periods of high uncertainty. We also show that uncertainty asymmetrically influences the transmission of positive and negative monetary policy surprises to stock market prices. The amplifying effect of uncertainty is found to be stronger for expansionary shocks than for contractionary shocks. Our robustness analysis confirms that financial uncertainty has a significant role in shaping the influence of monetary policy on the stock market.     

Wildlife viewing: The impact of money-back guarantees

Wildlife sightings are not always guaranteed. To address this risk, tour operators often offer a money-back guarantee as a refund mechanism. However, studies have overlooked the influences of such refund mechanisms on tourists' tour participation decisions and tourism revenue. We conducted choice experiments to examine the impact of such mechanisms using a case of Amami rabbit tourism in Japan. We found that the guarantee significantly influences the tourists’ decision-making and tour revenue. In particular, we found that the expected tourist participation rate and tour guide revenue vary drastically depending on the probability of the rabbit encounter. The maximum expected revenue from the tour with a 90% chance was about 20 times larger than that with a 10% chance. This indicates that conserving wildlife to maintain the sighting probability raises tour benefits, creating a win-win situation by balancing conservation and tourism development.     

分光光度法测定乳粉中胆碱含量的不确定度评定

根据《婴幼儿食品和乳品中胆碱的测定》测定乳粉中胆碱的含量,建立分光光度法测定乳制品中胆碱的不确定度数学模型,通过分析其测定的过程,确定影响结果的不确定度的主要分量来源,进行逐一分析并计算,评定出测量结果的合成标准不确定度和扩展不确定度。通过探讨这类测定方法的不确定度计算方法和步骤,建立一种简单、适用的测量不确定度的评估方法。     

基于多维频谱地图的干扰规避

针对复杂电磁环境下卫星移动通信系统可靠通信需求，利用频谱地图多维数据呈现优势，提出了基于多维频谱地图的干扰规避方法。通过建立卫星移动通信系统波束、时隙、子频带、干扰强度等多维信息关联的频谱地图，利用数据挖掘方法对频谱可用情况进行预测，基于预测结果及用户QoS(Quality of Service)需求生成干扰规避策略，通过星地联合频谱资源调配实现系统干扰规避。该方法为卫星移动通信系统干扰规避提供了一种全新的思路，可提升卫星移动通信系统干扰防护能力。     

MORE THAN A FEELING: CONFIDENCE,UNCERTAINTY, AND MACROECONOMIC FLUCTUATIONS

Economists, observers, and policy-makers often emphasize the role of sentiment as a potential driver of the business cycle. In this paper, we provide three contributions to this debate. First, we give an overview of the recent literature on the nexus between sentiment (considering both confidence and uncertainty) and economic activity. Second, we review existing empirical measures of sentiment, in particular consumer confidence, stock market volatility (SMV) and Economic Policy Uncertainty (EPU), on monthly data for 27 countries, 1985–2016. Third, we identify some new stylized facts based on international evidence. While different measures are surprisingly lowly correlated on average in each country, they are typically highly positively correlated across countries, suggesting the existence of a global factor or sizeable international spillovers of sentiment. Consumer confidence has the closest co-movement with economic and financial variables, and most of the correlations are contemporaneous or forward-looking, consistent with the view that economic sentiment is indeed a driver of activity.     

Risk,uncertainty, and leverage

Using mostly theoretical models and traditional risk/uncertainty measures (VIX index, panic, precaution, scary bad news, etc.), the current literature tries to clarify the risk/uncertainty-deleveraging pattern. The findings are not sufficient to explain the dynamic empirical relationship between modern risk/uncertainty indicators and leverage. We fill this gap in the literature by using US quarterly data, from 1985:1 to 2018:4, Granger causality tests, and a structural vector autoregression model. We find that commercial bank leverage rises when geopolitical risk and macroeconomic, policy, and equity uncertainty increase. Client-based business relationships of banks and high government borrowing from banks during crises periods are responsible for this relationship. We find that the leverage of broker-dealers and shadow banks declines when Chicago risk and macroeconomic, policy, financial, and equity uncertainty increase. We argue that the vulnerability of broker-dealers and shadow banks to the risk/uncertainty of the entire market system is responsible for this relationship.     

Expanding airport capacity of cities under uncertainty: Strategies to mitigate congestion

Airport capacity constraints are increasingly challenging the growth of air traffic. At the same time, decision-making about airport capacity investments is extremely complex, involving trade-offs. This paper’s objective is to optimise a privately owned airport system’s capacity investment decision in a city under demand uncertainty. Next to the investment size, our real options model incorporates the timing of the investment, as well as the cost of congestion. The results reveal that the larger a city’s initial airport capacity, the smaller its investment will relatively be and the lower the occupancy rate threshold at which investment will take place. We also show that, in case of a higher demand growth combined with more demand uncertainty, the city will benefit from a significantly larger investment, but made later at a higher occupancy rate. In this case, cities with a small initial capacity will sometimes even more than double current capacity. Higher airport charges and an increase in non-aeronautical revenues both lead to a later investment in more capacity, due to the increased project attractiveness. An increase in congestion costs results in a larger investment made earlier, in order to eliminate delays. Airport operational cost and capacity holding cost increases both lead to smaller investments.     

Public Provision of Private Goods,Self‐Selection,and Income Tax Avoidance

Redistributive taxation should benefit those with low earnings capacity rather than those who choose a lower income to obtain tax savings. Several contributions have highlighted how public provision of work complements can discourage people from lowering labor supply to diminish taxable income. We show how tax avoidance, previously neglected, can alter the conclusions regarding public provision. Tax avoidance breaks the link between labor supply and reported income. An agent reducing his reported income to escape taxes might no longer forego a publicly provided labor complement, because he can now lower his income by avoiding more rather than working less.     

Implementing efficient conservation portfolio design

Modern tools for cost-effective conservation reserve site planning require the planner to have information about spatial distributions of conservation costs and benefits. Climate change creates unprecedented uncertainty about future land values and species habitat ranges, such that conservation scientists cannot map costs and benefits with certainty anymore. This paper contributes to the literature on the economics of conservation in the face of climate change uncertainty. It advances a new method for using modern portfolio theory to choose lands to protect that yield total conservation returns with less uncertainty. It explores the implications for portfolio recommendations of variation in the correlations between ecological and land-value responses to climate change. It also tests the robustness of the method to shortcuts that might be taken to simplify analysis, identifying problems that arise if conservation costs are ignored in portfolio analysis and demonstrating when portfolio recommendations are sensitive to how ecological benefits are quantified.