Intergalactic market for organs

 Sometimes it seems that those who are most worried about markets for kidneys are worried about different things than those who are most worried about kidney patients.  

In case you were wondering, here's a video game to help you empathize with those you might otherwise disagree with: Space Warlord Organ Trading Simulator . It can be yours for just $19.99, much less than the cost of an eyeball.

"ORGANS. Everyone has them, and everyone wants them. You are an Organ Trader, the funnel for fleshy meat parts into a strange, evolving, and desperate universe full of clients.

"Contend with the cutthroat organ market. Trade viscera with dubious figures. Keep vampire-leech organs from devouring the rest of the goods inside your cargo hold. Flood galaxies with meat. Make a profit.

"This is Space Warlord Organ Trading Simulator: the sci-fi body horror market tycoon you didn't know you needed."

*************

And,  in case you aren't tuned into repugnant transactions via video game, here's a review of the game in the Guardian:

Space Warlord Organ Trading Simulator review – ghoulish satire of human greed

"It’s a premise as old as time: buy low, sell eyes. And spleens. More of a frantic clicker-game than a strategy sim, Space Warlord Organ Trading Simulator is only slightly more complex than a screensaver, though still chemically compulsive. Days are split between navigating a fleshy stock market, and trying to outbid cyborgs and dogs with names like Chad Shakespeare on the freshest human cuts. Think eBay as overseen by Harlan Ellison’s Allied Mastercomputer. You accept orders, wait for the organs to show up, grab them before a rival trader does and try to make a profit. As you progress, your customers get fussier. Organs are graded like trading cards, or Destiny loot drops. Where does a mythic lung come from, anyway? No time to think about it. The market wants what it wants."

**********

All of which reminds me of this old/new question:

Sunday, September 18, 2011

If it were legal to sell organs for transplantation, what would the ads look like?

SMBC on economists and money (and game theory)

 Here's Saturday Morning Breakfast Cereal on economists: https://www.smbc-comics.com/comic/econs

And it's a two-fer, economists are hot over at SMBC: https://www.smbc-comics.com/comic/holes

***********

Overcoming taboos concerning organ donation: a BBC broadcast

 Here's a BBC broadcast on generational change that talks about how young people are helping to overcome taboos regarding organ donation. (They chat with me about organ exchange, including a liver lobe for a kidney, and about having hairdressers talk to customers about deceased donation.)

Listen now

"Generation change: Part two, The Documentary

"BBC presenter Babita Sharma and correspondent Megha Mohan meet the young people from India, Nigeria, the United Kingdom, the United States and the United Arab Emirates fighting to change taboos around organ donation and for greater diversity in the critical fields of science, technology, engineering and maths. We also speak to Nobel Prize awarded contributors including kidney transfer campaigner and economist Alvin Roth as well as astronomer and Physics Laureate Andrea Ghez."

**********

Earlier: 

Monday, May 6, 2019

A (first) liver-kidney exchange

A call for kidney exchange in Brazil, in the Brazilian Journal of Nephrology

 Here's a call to allow kidney exchange in Brazil, to address the shortage of kidney transplants there.

Increasing transplantability in Brazil: time to discuss Kidney Paired Donation, by Juliana Bastos, David José de Barros Machado, and Elias David-Neto, Braz. J. Nephrol. • 17 Dec 2021 • https://doi.org/10.1590/2175-8239-JBN-2021-0141

"According to the 2020 Brazilian Dialysis Census, an estimated 45 thousand new patients started dialysis in the last year, totaling more than 144 thousand patients undergoing this therapy in the country. The estimated gross mortality of the patients varied between 18 and 20% in period 2016-2019.

"The number of KT performed in Brazil is increasing, although it is still less than half of the annual need estimated by the Brazilian Association of Organ Transplantation. Thus, the number of patients on the waitlist grows annually, having surpassed 26 thousand in 2020.

...

"Brazilian legislation does not contemplate the possibility of KPD. Law no. 9.434 from February 4, 1997 states that the removal of tissues, organs and body parts of a person in exchancge for payment or promise of reward, as well as for frivolous motives, constitutes a criminal offence37. Although organ exchange could be understood as a "promise of reward", it is evident that the law seeks to prohibit the commercialization of organs. In February 2020, a bill was implemented (95/2020) to add to the aforementioned law the following article: "For the effects of this Law, it shall not be considered commercialization the reciprocal donation of organs and tissues (exchange transplantation), so long as it does not involve any monetary benefits stemming from the act"; among other alterations, legitimizing the legality of KPD38. Similar legal obstacles have been overcome in other countries to encourage donor exchange28. It is important to remember that in KPD, all donors are non-relatives. According to national legislation, they must have prior legal approval, granted by the hospital ethics committee and the organ procurement center.

"In 2018, the Brazilian Federal Council of Medicine issued a statement opposing the implementation of KPD in Brazil39. The document stated, among other things, that KPD was a controversial concept, still in development and implemented only in a few countries; that it would incur high costs due to the logistical difficulties of the country, with its continental dimensions; that the increase in CIT could affect graft survival; that it would benefit only "a minimal part of the population"; and that it would jeopardize the credibility of the transplant program in Brazil39, an analysis that must be re-evaluated in light of currently reported data.

...

"We believe we have clarified in this review that, contrary to what has been said, KPD programs are no longer "controversial concepts in programs under development"(39 )but robust programs that are used almost everywhere in the world and show excellent results, comparable to other LDKT, despite focusing on a population with higher risk and a possible increase in CIT. Another critical issue relates to the main part of the affected population, the highly sensitized people who are sometimes referred to as non-transplantable. A national study in a single center estimated an increase of 7% in the total number of transplants with KPD (which is consistent with the results in the aforementioned countries), and an increase of more than 70% in the number of transplanted recipients with PRA > 80%41. If those figures were extrapolated nationally, for example, this would mean an increase of 420 LDKT in 2019.

"Thus, there seems to be no reason for Brazil not to join KPD, even if initially only locally and then implemented regionally/nationally according to the acceptance of the centers and the necessary logistical adaptation.

"At the HCFMUSP, KPD research seeks to determine the percentage of living donors rejected due to incompatibility and are eligible for KPD and to determine how many recipients would benefit from such a strategy. As part of this program, the first kidney exchange was carried out in Brazil in March 2020 and 28 additional pairs are currently under evaluation.

"Nowadays, all the leading countries in world are practicing this procedure and continue to develop it to include more recipients thanks to their excellent results.

...

"Finally, it is essential to emphasize that KPD also benefits those on the waitlist who do not have a donor, as it reduces the number of recipients waiting for an organ from a deceased donor. We believe that the Brazilian transplant program is mature enough to take up the challenge of starting a KPD program, primarily to benefit patients who have a low probability of receiving a transplant from a deceased donor."

Advertising, and kidney donation.

The Guardian has the story:

He put up a Times Square billboard in search of a kidney – and saved more lives than his own.  by Joshua Needelman

"Marc Weiner booked one of the world’s most visible advertising spots, hoping his life would change. He ended up changing the lives of dozens of others, too."

Costly information gathering to form preferences in school choice

 Here's a model suggesting that people for whom it is more costly to gather information about school quality will do less well in preference based school choice.

Inattention and Inequity in School Matching, by Stefan F. Bucher & Andrew Caplin, NBER WORKING PAPER 29586, DOI 10.3386/w29586

Abstract: The attractive properties of the Deferred Acceptance (DA) algorithm rest on the assumption of perfect information. Yet field studies of school matching show that information is imperfect, particularly for disadvantaged students. We model costly strategic learning when schools are ex ante symmetric, agree on their ranking of students, and learning is rationally inattentive. Our analytic solution quantifies how each student’s rank, learning costs and prior beliefs interact to determine their gross and net welfare as well as the extent and form of mistakes they make. In line with the evidence, we find that lower-ranked students are affected disproportionately more by information costs, generally suffering a larger welfare loss than higher-ranked students. Interactions between mechanism design, inattention and inequity are thus of first order importance.

**********

"The challenge faced by matching models with endogenous information is that students face three sources of uncertainty: signal-based, deriving from uncertainty about what information their learning strategy will produce; strategic, deriving from uncertainty about others’ submissions and thus the resulting matching outcome; and value-based, referring to the remaining uncertainty about the student’s valuation of their tch.

We introduce a tractable model of strategically rational inattention in a matching market that parsimoniously captures this complexity. To focus on the interplay with inequity we assume that schools agree on their ranking of students. For analytic tractability we assume that schools are ex ante symmetric (exchangeable) and that learning is rationally inattentive (Sims, 2003; Caplin and Dean, 2015; Matejka and McKay, 2015). While our symmetry assumption implies that schools are ex ante identical, it does not require that students’ valuations are independent across schools so that information on a school can update beliefs about others.

...

"A central finding is that DA exacerbates inequity. Lower-ranked students attain a lower fraction of their net welfare surplus under full information than do higher-ranked students, even if they have the same costs of learning. This is because lower-ranked students face greater uncertainty about the outcome resulting from any submission, which disperses and often dilutes their incentive to acquire information.

...

"The fact that lower-ranking students are more likely to be matched with a school further down their list results in very unequal learning incentives..."

College as a Marriage Market, by Lars Kirkebøen, Edwin Leuven, Magne Mogstad

Here's a recent working paper about college and marriage in Norway:

College as a Marriage Market, by Lars Kirkebøen, Edwin Leuven, Magne Mogstad

Abstract: Recent descriptive work suggests the type of college education (field or institution) is an important but neglected pathway through which individuals sort into homogeneous marriages. These descriptive studies raise the question of why college graduates are so likely to marry someone within their own institution or field of study. One possible explanation is that individuals match on traits correlated with the choice of education, such as innate ability, tastes or family environment. Another possible explanation is that the choice of college education causally impacts whether and whom one marries, either because of search frictions or preferences for spousal education. The goal of this paper is to sort out these explanations and, by doing so, examine the role of colleges as marriage markets. Using data from Norway to address key identification and measurement challenges, we find that colleges are local marriage markets, mattering greatly for whom one marries, not because of the pre-determined traits of the admitted students but as a direct result of attending a particular institution at a given time.

 Here's a summary from the Becker-Friedman Institute:

College as a Marriage Market, by Larn Kirkebøen, Edwin Leuven, Magne Mogstad

"The context of the authors’ study is Norway’s postsecondary education system. The centralized admission process and the rich nationwide data allow them to observe not only people’s choice of college education (institution and field) and workplace, but also if and who they marry (or cohabit with), and to credibly study effects of college enrollment. The authors find the following:

"The type of postsecondary education is empirically important in explaining whom but not whether one marries. 

"Enrolling in a particular institution makes it much more likely to marry someone from that institution. These effects are especially large if individuals overlapped in college, are sizable even for those who studied a different field and are not driven by geography.

"Enrolling in a particular field increases the chances of marrying someone within the field but only insofar as the individuals attended the same institution. Enrolling in a field makes it no more likely to marry someone from other institutions with the same field. 

The effects of enrollment on educational homogamy (or marriage between people from similar backgrounds) and assortativity vary systematically across fields and institutions, and tend to larger in more selective and higher paying fields and institutions. 

Only a small part of the effect of enrollment on educational homogamy can be attributed to matches within the same workplace.

Lastly, the effects on the probability of marrying someone within their institution and field vary systematically with cohort-to-cohort variation in sex ratios within institutions and fields. This finding is at odds with the assumption in canonical matching models of large and frictionless marriage markets.

Taken together, these findings suggests that colleges are effectively local marriage markets, mattering greatly for the whom one marries, not because of the pre-determined traits of the students that are admitted but as a direct result of attending a particular institution at a given time."

Will unionization at universities change the United Auto Workers?

 There is an increasing presence of labor unions at American universities, which may well bring big changes to those universities. Here is an article from the Chronicle of Higher Ed suggesting that it may also bring big changes to some labor unions.

A New Force in American Labor: Academe--One in five members of the United Automobile Workers is in higher education.By Barry Eidlin, NOVEMBER 29, 2021

"But why would a philosophy major at UC Berkeley join a campaign to change how an auto-worker union chooses its leadership? As a tutor in the University of California system, Huang is a member of UAW Local 2865 — along with other academic workers like graduate-student instructors and “readers,” students hired to grade assignments. With 19,000 members, Local 2865 is now the second-largest local in the entire union.

"Organizing those members has been challenging. “It’s hard enough to get them to recognize themselves as workers,” explained Keith Brower Brown, a Ph.D. candidate in the UC Berkeley geography department. “It’s a whole other step to get them to embrace that they’re a part of this international union, and they have a stake in changing the leadership of the union.” To help colleagues take that step, Cyn Huang tries to connect the referendum to familiar issues: “You explain how the ability to elect top leadership could lead to better contracts, greater accountability, new organizing. It makes sense to people. Once they hear that, it’s pretty intuitive.”

"In recent decades, academic workers like Huang and Brown have become an increasingly large part of the UAW. This group — which includes undergraduate tutors, graduate-student teachers and researchers, postdoctoral fellows, and adjunct instructors — now constitutes roughly one-fifth of the UAW’s active membership."

************

The UAW has organized student workers at Harvard, and just reached an agreement on a new contract. Some details are here:

https://studentunionization.harvard.edu/contract-overview 

Report from Dagstuhl: Matching Under Preferences: Theory and Practice, Edited by Haris Aziz, Péter Biró, Tamás Fleiner, and Bettina Klaus

 Matching theory was alive and well during the pandemic. Here's a report of the (partially in person) Dagstuhl Seminar, July 25–30, 2021 – http://www.dagstuhl.de/21301

Report from Dagstuhl Seminar: Matching Under Preferences: Theory and Practice, Edited by Haris Aziz, Péter Biró, Tamás Fleiner, and Bettina Klaus

"This report documents the program and the outcomes of Dagstuhl Seminar 21301 “Matching Under Preferences: Theory and Practice”. The seminar featured a mixture of technical scientific talks, survey talks, open problem presentations, working group sessions, five-minute contributions (“rump session”), and a panel discussion. This was the first Dagstuhl seminar that was dedicated to matching under preferences.    

...

"The seminar was conducted in a hybrid manner, with 15 participants attending the seminar physically from the Dagstuhl center and 34 participants attending online.

...

"The four main focus topics of the workshop were the following ones.

1. Matching markets with distributional constraints,

2. Probabilistic and Fractional Matching,

3. Matching in online and dynamic settings, and

4. Matching Markets and machine learning."

***********

As a sign of the times, this non-technical working group session caught my eye:

"4.1 Gender Terminology in Bipartite Stable Matching

Robert Bredereck (HU Berlin, DE) License Creative Commons BY 4.0 International license © Robert Bredereck

"Bipartite Stable Matching is classically presented as “Stable Marriage” with one side being men and the other side being women. Meant as illustration and not as proposal for real marriage, the many successful applications of the model are all in completely different domains. The classical terminology, however, can be easily misunderstood and becomes questionable at latest when one side behaves always passive while the other behaves always active, one site manipulates while the other is honest, there is external manipulation, or some couples are forced or forbidden.

"Participants of the seminar discussed the seriousness of these issues in particular in situations where people from outside the community are involved (teaching, grant proposals, etc.). To avoid misunderstanding many participants are using alternative terminologies:

"sportsmen ↔ sportswomen (mixed teams such as tennis)

"leaders ↔ followers (dancing)

"doctors ↔ hospitals

"student ↔ colleges

"workers ↔ companies

"workers ↔ apprentices

"mentors ↔ mentees

"While some of the alternatives even allow to keep using different grammatical gender for the two sides (and so allow to write easily comprehensible texts), other alternatives fit better with the manipulation setting. Some of these alternative terminologies are already established in more specialized or generalized settings of Stable Matching, but may still qualify for the illustration of Bipartite Stable Matching. Another possibility in use is to keep the marriage market terminology while clearly putting it into a historical context."

*****

I've used many of these terms when describing matching, but I wonder if "leaders" and "followers" in the context of dancing will solve the problem that this discussion of terminology is aimed at...

Better LAT than never: Living Apart Together for older romantic relations

 Marriage is not the only way that people can romantically partner, and of course young people are the pioneers in many new forms of household formation.  But here are two news stories that say Living Together Apart (LAT) relationships are growing among older and often previously married couples.

The NY Times has a story focusing on older couples:

Older Singles Have Found a New Way to Partner Up: Living Apart. Fearing that a romantic attachment in later life will lead to full-time caregiving, many couples are choosing commitment without sharing a home. By Francine Russo

"With greater longevity, the doubling of the divorce rate since the 1990s for people over 50 and evolving social norms, older people like Ms. Randall are increasingly re-partnering in various forms. Cohabitation, for example, is more often replacing remarriage following divorce or widowhood, said Susan L. Brown, a sociologist at Bowling Green State University in Ohio.

...

"As researchers study those who do partner, however, they find that increasing numbers are choosing a kind of relationship known as LAT (rhymes with cat), for “living apart together.” These are long-term committed romantic relationships without sharing (or intending to share) a home.

"“A big attraction of LAT is to avoid the potential responsibility of being a full-time caregiver,” said Ingrid Arnet Connidis, an emerita sociology professor at Western University in London, Ontario. “Women cared for their children, parents and spouse, and want to avoid getting into these traditional gender roles.”

"While researchers have not yet delved deeply into the demographics of those in LAT relationships, anecdotally it seems to be more prevalent among those at high enough socioeconomic levels to be able to maintain separate households. In general, there is evidence that wealthier people who are single later in life are more likely to re-partner."

*************

The WSJ has a story focusing on new couples in the midst of raising kids:

The Secret to These Successful Marriages? Living Apart. The number of married couples who live apart is small but growing. Here’s how they say the arrangement helps their families and their relationships   By Clare Ansberry

"Many couples who live apart have been married before and don’t want to uproot their children from homes, schools and friends, or can’t because of joint-custody arrangements.

...

"The number of married people living apart, which includes military couples, is still small but rose 4.8% in the last decade to 3.6 million, according to figures from the Census Bureau."

An Interview Match for medical residents and fellows--a preliminary proposal

 There is a lot of concern in the graduate medical education community that too much time and treasure is being spent on too many unproductive interviews prior to the submission of rank order lists for the Match.  Here's discussion of a proposal for an interview match, to precede the interview stage before the actual NRMP Match.

Explaining a Potential Interview Match for Graduate Medical Education, by Irene Wapnir, MD; Itai Ashlagi, PhD; Alvin E. Roth, PhD; Erling Skancke, MS; Akhil Vohra, PhD; Irene Lo, PhD; Marc L. Melcher, MD, PhD, J Grad Med Educ (2021) 13 (6): 764–767.  https://doi.org/10.4300/JGME-D-20-01422.1

"Residency and fellowship candidates are applying to more programs to enhance their chances of securing interviews and matching favorably. The COVID-19 pandemic has shifted interviews to video formats, which lowers interview-associated costs for applicants but may further increase application numbers.1  While a candidate's application to a training program communicates some interest in the program, the relative amount of interest is obscured when candidates apply to large numbers of programs. We suspect that, as a result, programs host large numbers of low-yield interviews.

"The number of interviews is steadily increasing, and there is widespread agreement on the need to ease congestion in the pre-Match evaluation process.2  Proposals to reduce this burden include signaling (organized, centrally-controlled protocol for limited communication of interest),3–5  capping the number of applications or the number of interviews,6,7  and an early acceptance matching program as in college admissions.8,9 

"We propose another solution, an “interview match” to address the expanding number of interviews.10  An interview match enables candidates and programs to express preferences privately by ranking their interview choices individually or in tiers. This may ease congestion in the “marketplace,” reduce costs for candidates, favor interviews that are more likely to lead to a match in the final Match, and avoid interviews unlikely to convert to a match. An interview match algorithm would match based on the same “deferred-acceptance” algorithm currently used by the National Resident Matching Program but adapted to a “many-to-many” setting where candidates and programs receive multiple interviews."

70: three score years and ten

 If you persist, you find that 70 isn't nearly as old as you once imagined it to be (and  as it used to be, maybe not even that long ago). Certainly three score years and ten is no longer an inspirationally long life.

(The Hebrew verse 10 of Psalm 90 simply says "70 years." I think that "three score and ten" is a flourish originally introduced in the King James translation.

יְמֵי-שְׁנוֹתֵינוּ בָהֶם שִׁבְעִים שָׁנָה

"The days of our years are threescore years and ten, or even by reason of strength fourscore years...")

Earlier this month I was surprised at what I thought would be only a Hanukkah party, by a pre-birthday celebration in which a number of my students located a pretty big group of my former students and postdocs to produce this video of birthday greetings and reminisces. 

I've been lucky in my students and young colleagues, long ago and still today.  Thanks to Alex and the local gang, to all those on the video, and to all those who weren't found by the surprise team, who are all remembered fondly and gratefully...

One Hundred Years of Game Theory: Nobel Symposium in Stockholm

 I'm in Stockholm for a celebration of the 100th anniversary of Emile Borel's 1921 paper on Game Theory.

It's a three day conference, Friday through Sunday, but I gather that only Sunday will be publicly available on Zoom.

Here's the schedule for all three days:

NOBEL SYMPOSIUM “ONE HUNDRED YEARS OF GAME THEORY”, DECEMBER 17-19, 2021

My talk is on "Game theory and economic engineering: Dealing with big strategy sets, including invention of new strategies"

And here's the announcement and Zoom link for Sunday, Dec 19 (the day Borel's paper was presented in 1921)

One Hundred Years of Game Theory: Future Applications and Challenges

"On December 19, 1921, the mathematician Emile Borel published a paper which laid the foundation of game theory. He offered a new framework for analysis in economics, political science, and other social and behavioral sciences. The centennial of this publication is a good occasion to ask where we may look today for the next breakthroughs that will be important for future economics and other social sciences, and for biology and computer science. What are the most promising directions for application? What are the most important challenges?

Start time: 2021-12-19 at 14:30

End time: 2021-12-19 at 16:30

Location: via Zoom. Link will be sent to the email address provide in the registration form."

************

I hear that some of the scheduled speakers who expected to come in person on Sunday will, at the last minute, not be able to do so, due to various outbreaks of Covid, particularly at Cornell.  Fortunately we've become good at using Zoom...

Muriel Niederle wins the Austrian Käthe-Leichter-Preis for "outstanding achievements in the field of social, human and cultural sciences"

 Here's the announcement (with help from Google Translate):

Lifetime Achievement Prize goes to Edeltraud Hanappi-Egger (WU), Käthe-Leichter State Prize to Christine Zulehner (University of Vienna) and Muriel Niederle (Levin Endowed Professorship in Stanford)

"Vienna (OTS) - The Käthe-Leichter State Prize for women's studies, gender research and equality in the world of work honors outstanding achievements in the field of social, human and cultural sciences.

"Women's Minister Susanne Raab presented this year's prizes on Wednesday: The Lifetime Achievement Prize went to Dr Edeltraud Hanappi-Egger, who works at the Vienna University of Economics and Business, and the Käthe-Leichter State Prize to Dr Christine Zulehner, who works at the university Vienna, and to Dr. Muriel Niederle, who teaches at Stanford University."

Virtual interviewing increased the number of interviews by (and of) candidates for medical residencies

 Here's an article on virtual interviewing of candidates for medical residencies (about which, see also this post about Erling Skancke's work on interviewing):

Beshar I, Tate WJ, Bernstein D. Residency interviews in the digital era, Postgraduate Medical Journal Published Online First: 05 October 2021. doi: 10.1136/postgradmedj-2021-140897

"Halfway through the interview cycle, however, questions were raised about system-level equity of virtual interviewing. In December 2020, the Association of American Medical Colleges (AAMC) released an open letter citing ‘a maldistribution in residency interview invitations’, with the ‘highest tier applicants hav(ing) so many interviews’.15 The letter, addressed to both programme directors and students, called on programmes ‘to recruit a diverse pool of residents’ and encouraged students ‘to release[e] some interviews if you are holding more than needed, allowing your fellow students to access those interview opportunities’.15 Medical school deans began encouraging competitive students to forgo interviews. In the words of the Dean of students at the UC College of Medicine: ‘They need to identify a reasonable number to have a successful match and release others so their peers who need them can have them’.6 By some estimates, programmes invite the same pool of highly qualified applicants, with just 7%–21% of the applicant pool filling 50% of the interview slots in some specialties.16 Meanwhile, a survey of plastic surgery programme directors demonstrated nearly one in three increased the number of interview offers per available residency spot.

"At our institution—Stanford School of Medicine—and as applicants of the 2020–2021 cycle ourselves—we saw the effect of this firsthand. We administered a survey to all students participating in the match process in both the 2019 (in-person) and 2020 (virtual) years. In the survey, respondents identified the residency programme or programmes to which they applied as well as the number of interviews they attended. Of Stanford’s 2019 and 2020 graduating classes, 83.7% (n=72) and 62.3% (n=62), respectively, completed our survey.

"Of the 2019 applicants, 97.2% (n=70) reported residency interviews that required airline travel, compared with 0% of the 2020 applicants. The median number of interviews for the 2019 applicants was 8, compared with 14 for the 2020 applicants. Across the 2 years analysed, all fields showed an increase in the number of interviews accepted (table 1). Of the four fields with the most applicants, the largest per cent change was in anaesthesia (244%), followed by ophthalmology (216%), internal medicine (144%) and psychiatry (128%), respectively. On average, across all specialties, the number of accepted interviews changed by 160%.

The costs of deceased donor organ recovery in the U.S., by Held et al. in the journal Transplantation

 Here's the report of an investigation into organ procurement costs and finances:

Cost Structures of US Organ Procurement Organizations by Held, Philip J. PhD1; Bragg-Gresham, Jennifer L. PhD2; Peters, Thomas G. MD3; McCormick, Frank PhD4; Chertow, Glenn MD, MPH1; Vaughan, William P. BS5; Roberts, John P. MD, Transplantation. 2021;105(12):2612-2619. doi:10.1097/TP.0000000000003667.

Abstract: "Background. The goal is to provide a national analysis of organ procurement organization (OPO) costs.

"Methods. Five years of data, for 51 of the 58 OPOs (2013-2017, a near census) were obtained under a FOIA. OPOs are not-for-profit federal contractors with a geographic monopoly. A generalized 15-factor cost regression model was estimated with adjustments to precision of estimates (P) for repeated observations. Selected measures were validated by comparison to IRS forms.

"Results. Decease donor organ procurement is a $1B/y operation with over 26 000 transplants/y. Over 60% of the cost of an organ is overhead. Profits are $2.3M/OPO/y. Total assets are $45M/OPO and growing at 9%/y. "Tissue" (skin, bones) generates $2-3M profit/OPO/y. A comparison of the highest with the lower costing OPOs showed our model explained 75% of the cost difference. Comparing costs across OPOs showed that highest-cost OPOs are smaller, import 44% more kidneys, face 6% higher labor costs, report 98% higher compensation for support personnel, spend 46% more on professional education, have 44% fewer assets, compensate their Executive Director 36% less, and have a lower procurement performance (SDRR) score.

"Conclusions. Profits and assets suggest that OPOs are fiscally secure and OPO finances are not a source of the organ shortage. Asset accumulation ($45M/OPO) of incumbents suggests establishing a competitive market with new entrants is unlikely. Kidney-cost allocations support tissue procurements. Professional education spending does not reduce procurement costs. OPO importing of organs from other OPOs is a complex issue possibly increasing cost ($6K/kidney)."

...

"CONCLUSION

"In the United States, deceased-donor organ recovery costs total $1B per year and represent approximately one-third the cost of an organ transplant procedure. Direct and indirect costs are reported on CMS required OPO cost reports, confirming that over half of all costs are indirect, such as the costs of organ procurement personnel, professional education, and other personnel expenses. Kidney cost increases over the 5-y study period seem reasonable compared with all medical care cost increases but increased at rates in excess of the cost increases transplant centers experienced for transplant procedures. And, kidney importation (from other OPOs) adds substantially to cost adding $4K-$6K per organ. OPO revenue over expense is largely due to profits from tissue recovery activities. Cost variations of over 100% across areas suggest less than socially efficient cost controls. The strong financial position of OPOs suggests that fiscal limits are not a likely explanation for the shortage of organs for transplantation.

"In considering individual OPOs, 2 levels of kidney costs (>$40K/kidney and <$40K) disclosed both statistically and clinically significant differences. The highest-cost OPOs (>$40K/kidney) are associated with higher direct costs (including more imported organs), higher compensation for support staff and procurement coordinators, higher professional education spending, and lower total assets, fewer organs procured, and lower performance measures-among other factors. Assessment of structural factors such as these may lead to opportunities to decrease cost and improve efficiencies. The US OPO enterprise is substantial, yet future OPO efficiency and performance improvements through competition appear unlikely considering OPO assets, current practices, and regulatory oversight issues. The inefficient financial incentives built into the U.S. OPO structure include both monopoly markets and self-reported cost reimbursement. These characteristics do not compel critical assessment, which could lead to organizational changes and more effective mission capability."

Working remotely may lessen income inequality between men and women: Claudia Goldin in the WSJ

 Here's Claudia Goldin in the WSJ, on how income inequality between men and women may be lessened by the growth of remote work. (She argues that women pay a price for flexible hours, since the highest paying jobs are "greedy" for long and on-call work.)

How the Pandemic Could Make the Future Brighter for Women in the Workplace. It could lead to less gender inequality at work, and more equity at home By Claudia Goldin Dec. 11, 2021

"Whereas the job with flexible hours paid far less than the greedy job before the pandemic, previously greedy jobs are now more flexible and the previously flexible jobs are now more productive. The working couple with children can now have a more equitable household without giving up as much income. The on-call parent will be able to compete for the previously greedy job, and employers will expand the previously flexible jobs, because these jobs have become more productive. As a result, the difference between the wages of the previously greedy and previously flexible jobs will narrow.

"Consider the mergers-and-acquisition work that once had to be done in Tokyo, or the contract that needed to be signed in Zurich. They actually don’t need to be done in person, we have learned. The on-call, at-home parent, generally the mother, hadn’t been able to do these transactions. But now they can be accomplished without being away during the evening and without flying across an ocean. The flexible job has become more productive and the greedy job has become more flexible."

What we know about labor market interviews

 Erling Skancke is on the job market from Stanford this year. You should interview him. If you do, you'll learn a lot about interviews, which are the subject of his job market paper, which provides a lot of new insight into an important practical set of isssues.

Skancke, Erling, Welfare and Strategic Externalities in Matching Markets with Interviews (November 10, 2021). Available at SSRN: https://ssrn.com/abstract=3960558 or http://dx.doi.org/10.2139/ssrn.3960558

Abstract: Recent debate in the medical literature has brought attention to issues with the pre-match interview process for residency and fellowship positions at hospitals. However, little is known about the economics of this decentralized process. In this paper, I build a game-theoretic model in which hospitals simultaneously decide on which doctors to interview, in order to learn their preferences over doctors. I show that increased interview activity by any hospital imposes an unambiguous negative welfare externality on all other hospitals. In equilibrium, both hospitals and doctors may be better off by a coordinated reduction in interview activity. The strategic externality is more subtle, and conditions are derived under which the game exhibits either strategic complementarities or substitutes. Moreover, an increase in market size may exacerbate the interview externalities, preventing agents from reaping the thick market benefits that would arise in the absence of the costly interviews. This effect increases participants' incentives to match outside of the centralized clearinghouse as markets become thicker, jeopardizing the long-term viability of the clearinghouse. The model also provides new insights into several market design interventions that have recently been proposed.

Disrupting black markets: call for papers

 Laws banning markets often create black markets. And the same technologies that facilitate legal markets may do so for illegal markets that we would like to extinguish, e.g. involving human trafficking, trade in endangered species or drugs, ransomware, etc.

How can we control such markets?

Here's a call for papers:

Call for Papers , Annals of Operations Research 

Special Issue: Applications of Operations Research and Data Science in Disrupting Illicit Markets 

Guest Editors: Mahdi Fathi, University of North Texas, TX, USA, mahdi.fathi@unt.edu 

Panos M. Pardalos, University of Florida, FL, USA, pardalos@ufl.edu 

Dursun Delen, Oklahama State University, OK, USA, dursun.delen@okstate.edu 

Stefan Gold, University of Kassel, Germany, gold@uni-kassel.de

 Marzieh Khakifirooz, Tecnologico de Monterrey, Mexico, mkhakifirooz@tec.mx 

Full paper submission deadline: 31 August 2022 

The first children with germline-edited genomes are growing up: the CRISPR story so far

 Nature has the story:

The CRISPR children.  In China, the first children with germline-edited genomes are growing up.  by Vivien Marx

"Three years ago, the world was in uproar after a journalist broke the news about two babies born with genomes edited with CRISPR-Cas9. He Jiankui had been invited to speak in the session on human embryo editing at the Second International Summit on Human Gene Editing. Some of He’s advisors thought he should speak about the twins, while others advised him to wait until his manuscripts were published, and He was purportedly leaning toward focusing just on preclinical work. Then, when the news of the twins’ birth was revealed, he adjusted existing slides to address the news.

....

"The goal of these heritable gene edits was to generate HIV-resistant people, by introducing germline mutations into the C-C chemokine receptor type 5 (CCR5) gene, which encodes a co-receptor for HIV. This thinking was roundly criticized by researchers and ethicists because of a lack of a medical need given the availability of antiretroviral treatments.He’s rationale for germline editing was that the gene was well studied, that HIV remains a devastating disease and that HIV infection status leads to discrimination. The participants in this study were HIV-discordant couples: the wives are HIV negative and their husbands are HIV positive and being treated with antiretroviral drugs.

...

"As the chorus of criticism around the experiments mounted in the days after the announcement, He disappeared from public view. Some assumed he was given a kind of escort who accompanied him around campus and monitored him. In January he was fired from his university post, and apparently detained some time thereafter.The Chinese authorities initially touted He’s achievement, then backtracked, condemned the work and shuttered the lab. After a trial in Nanshan District People’s Court behind closed doors, He was sentenced to a fine and three years in jail for ‘illegal medical practice’, along with two members of his team.

...

"One key concern for the children is genetic mosaicism—a condition in which different cells from the same individual have different genomes. Such conditions can occur naturally during development, for example through post-zygotic mutations, when mitosis proceeds irregularly and mutated cells persist. It can also happen when, after an environmental insult, a DNA break is not properly repaired.

...

"Whitehead Institute researcher Rudi Jaenisch says that mosaicism is a major problem with current approaches to heritable embryo editing. When genome edits take place after a zygote has become a two-cell or multicellular blastocyst—as likely occurred in He’s experiments—the edited and unedited cells keep dividing.

...

"Adashi fears that, given how imperfect the gene-editing tools are, the type of genetic and genomic “mayhem” that can result might lead to the loss of entire chromosomes or pieces of them. “Basically they could have a scrambled genome,” he says about the girls. He points to several papers showing such damage when CRISPR-Cas9-based gene editing is performed in human embryos.

...

"Rather than edit embryos, both Jaenisch and Church think that if germline gene editing is ever considered, it would be more promising to, for example, edit spermatogonial stem cells that give rise to sperm. But for now neither heritable gene editing in embryos nor germ-cell editing are considered ready for application in people.

"What happened in He’s lab, says Musunuru, is a textbook ethics violation that should be extensively analyzed and discussed. To date, the manuscripts describing the work that led to the gene-edited children have not been published in a journal or placed on a preprint server (Box 2). But since the birth of Lulu, Nana and Amy, a host of reports about the safety and ethics of gene editing have been published.

...

"They may well grow up healthy, says Adashi. Considering the risks endured in their creation, that would be a wonderful outcome. But he worries that germline gene editing “has a significant potential to cause harm rather than good.”

“How and if it will manifest is unknown,” he says. It’s certainly no way “to start life.”

***********

Earlier:

Monday, December 14, 2015

Technology watch: does Crispr create a new class of repugnant transactions?