David Manlove writes to invite applications for postdocs with him and Daniel Paulusma to work on kidney exchange.
"There are three positions available to work on algorithms and software for kidney exchange as part of the EPSRC-funded KidneyAlgo project: New Algorithms for UK and International Kidney Exchange (https://gow.epsrc.ukri.org/NGBOViewGrant.aspx?GrantRef=EP/X013618/1 and https://gow.epsrc.ukri.org/NGBOViewGrant.aspx?GrantRef=EP/X01357X/1).
"Wilderness medicine" sounds like the sort of medicine you hope you never need as a patient. But there is a medical fellowship program that draws on a cross-disciplinary group of docs, and their decentralized labor market has run into the usual difficulties. Here's a report on a new centralized clearinghouse, run in-house and partly manually, following a simulated run.
Davis, Christopher A., Stephanie Lareau, Taylor Haston, Arun Ganti, and Susanne J. Spano. "Implementation of a Specialty Society‒Sponsored Wilderness Medicine Fellowship Match." Wilderness & Environmental Medicine (2022, in press).
"Previously, wilderness medicine (WM) fellowships offered spots to applicants using an offer date. Due in part to increases in the number of WM fellowships and applicants, in 2021, the WM program directors (PDs) agreed to conduct the first WM fellowship match through the Wilderness Medical Society graduate medical education committee. This article outlines the process used and demonstrates its feasibility.
...
"Wilderness Medicine (WM) fellowships previously filled positions using an offer-date set by fellowship directors each fall.1 Applicant(s) were called in the order of preference by each director until all available positions were filled. Once called, applicants would have 30 min to accept or decline the offer. Limitations included the potential for verbal, nonbinding offers to influence candidates’ and directors’ actions on the offer day, as well as pressure on candidates to accept initial offers owing to the lack of knowledge regarding potential forthcoming offers. These concerns cast uncertainty on whether participants were placed in a disadvantageous position by the offer-date system.
...
"Formal fellowship matching services are not exclusively managed by the NRMP; other businesses, the military, and professional societies host matching services. The San Francisco match currently provides fellowship matching services to 22 subspecialties.6 The military does not use a computer-generated match list; the selection committee arranges negotiated pairings between programs and applicants, with the ability to place an applicant in a program they did not rank.7 The American Urological Association, in conjunction with the Society of Academic Urologists, has overseen the urology residency match program for >35 y, which includes fellowship matches.
...
"After completion of the simulated trial/test match, all PDs and WMS GME committee members agreed to participate in the proposed inaugural WM match via email or telephone verification. The deadline of October 25, 2021 was set for the submission of all rank lists to the WMS staff member by all participating applicants and programs. Individual emails were sent to both the programs and applicants to encourage timely completion of the process. On October 28, 2021, at 0900 PST/1200 EST, initial emails were sent simultaneously to each applicant and each PD to inform them of either a successful match or eligibility for the secondary match.
...
"A total of 13 programs and 15 applicants completed the match process. After the first round, 11 of 15 applicants had matched, and 2 programs and 4 candidates had the opportunity to complete the secondary match. During the secondary match period, the unfilled programs2 withdrew, obviating the need for the secondary match.
...
"Many PDs noted in 2021 that they had a significant increase in the number of applicants in 2020 and cited this as motivation for moving away from the previous telephone-based offer system and pursuing a match for the subsequent year."
Here's a report on 2-way liver exchanges conducted at Max Center for Liver and Biliary Sciences, Max Saket Hospital, New Delhi, India, each between two manually matched, non-anonymous patient-donor pairs.
Paired Exchange Living Donor Liver Transplantation: A Nine-year Experience From North India by Agrawal, Dhiraj MD, DM1; Saigal, Sanjiv MD, DM, MRCP, CCST1; Jadaun, Shekhar Singh MD, DM1; Singh, Shweta A. MD, DM1; Agrawal, Shaleen MS, MCh1; Gupta, Subhash MS, MCh1
...
"Although the basic framework for LPE was adopted from the kidney paired exchange program, LPE or swap LDLT is inherently distinct, more complex, and associated with more technical, logistical, and ethical challenges.11 Both recipient and donor surgeries are long-duration surgeries and must be flawless to ensure minimum morbidity and mortality. The living donor partial hepatectomy is associated with approximately 10 times greater mortality than living donor nephrectomy, and the morbidity ranges from 9% to 24%, depending on the type of hepatectomy performed.12,13
"The logistics involved in a single-center simultaneous LPE are extensive with 4 simultaneous operations: 4 sets of teams of anesthetists, surgeons, nurses, and technicians. The blood bank must be equipped with requirements for major surges. For a single LDLT operation, it is estimated that >18 skilled team members may be needed, and in LPE, this number is doubled. Furthermore, any unanticipated difficulty due to operative anatomical variations may potentially impact both recipients’ outcomes. These constraints limit the LPE to a few high-volume centers.
...
"After the recipients and donors of an incompatible pair showed willingness for LPE, the medical suitability of each donor and recipient pair and the equity of the exchange were confirmed by a multidisciplinary forum comprising transplant hepatologists, transplant surgeons, social workers, and psychiatrists. Once 2-by-2 donor-recipient pairs were successfully matched, the transplant team informed the pairs and arranged a meeting wherein each recipient could meet their intended donor in the presence of the transplant team to discuss any anticipated issues. All participants who participated in the exchange program underwent a thorough psychosocial assessment to minimize the possibility of conflict. Donors have clarified that a poor outcome is possible in any LDLT, and in rare circumstances, their intended recipient can have a poor outcome. Through several in-depth counseling sessions, all 4 parties were independently and jointly informed about the suitability and structure of the exchange, the entire procedure, and the expected results. They were also provided with alternative options such as ABOi transplantation, deceased donor liver transplantation (DDLT), and associated risks and cost-effectiveness. Donors were allowed to opt out at any step during the process, and care was taken to avoid coercion. After the development of basic trust between all 4 participants, informed consent and a confidential agreement were signed. In India, there is a strict legal requirement for LDLT that the donor and recipient should be related to either blood or marriage. However, since LPE is an unrelated, directed donation, special approval was obtained from the ethical committee of the local authority.
...
"The 17 pairs of LPE donations included 34 directed living donors with a median age of 38.5 y (19–51 y), of which 27 were females. All donors were first-degree relatives of the recipients and included 18 spouses, 11 children, and 5 siblings.
...
"ABO-incompatible donor-recipient pairs are encouraged to visit our center regularly, and as this is a common problem, not surprisingly, they are often able to meet another ABOi pair at the center. Furthermore, our coordinators have the telephone numbers of recipients looking for paired exchanges, and they facilitate such pairs to speak to each other on the phone. Once they show willingness to participate in the paired exchange program, their papers are submitted to the government-appointed authorization committee for clearance. Theoretically, in LPE donations, there is a potential for emotional disconnect, as opposed to ABO-incompatible LDLT. Interestingly, in our series of 34 transplants, the donor felt that they had donated to their own recipient, and on follow-up, all 4 participants seemed to have developed great emotional bonding.
"At our center, >75% of donors are first-degree relatives as “nonnear relatives” find very difficult to get governmental clearance. LPE is a transplantation between unrelated people and is, therefore, liable for exploitation. However, The Transplant Act has built in safety features as it allows only “first degree relatives” to be considered for paired exchange and also bars the organ exchanges between Indian and foreigners.
...
"It is possible that, in the future, transplant centers in India will act in tandem, and we will be able to operate pairs at 2 different centers. However, under the existing hospital-based government-appointed authorization committee, this may not be feasible unless a central clearing agency is set up."
There are many reasons why communities object to prostitution, and it will not surprise you to learn that it reduces house prices in its immediate neighborhood. Here's a study that takes advantage of the closing of some brothels in Amsterdam:
Giambona, Erasmo, and Rafael P. Ribas. "Unveiling the Price of Obscenity: Evidence from Closing Prostitution Windows in Amsterdam." Journal of Policy Analysis and Management (2022).
Abstract: "Does legitimating sinful activities have a cost? This paper examines the relationship between housing demand and overt prostitution in Amsterdam. In our empirical design, we exploit the spatial discontinuity in the location of brothel windows created by canals, combined with a policy that forcibly closed some of the windows near these canals. To pin down their effect on housing prices, we apply a difference-in-discontinuity (DiD) estimator, which controls for the precise location of brothel windows and the effect of other policies and local developments. Our results show that the housing prices are discontinuous at the bordering canals, and this discontinuity nearly disappears after closures. The discontinuity is also found to decrease with the distance to brothels, disappearing after 300 yards. Our estimates indicate that homes right next to sex workers were 30 percent cheaper before the closures. This result seems unrelated to the presence of other businesses, such as bars and cannabis shops. Instead, the price discount is partly explained by petty crimes. However, 73 percent of the effect remains unexplained after controlling for many forms of crime and risk perception. Our findings suggest that households tend to be against the visible presence of sex workers and related nuisances, reaffirming their marginalization."
And here's the concluding paragraph:
"Overall, the legalization of prostitution can have social and economic benefits. However, our work suggests that even in a city where prostitution has been tolerated for centuries and is currently legalized, residents avoid living near brothels. This aversion results in sizable property value losses. The takeaway for policymakers is that social norms and related nuisances influence the marginalization of sex workers beyond any regulations attempting to legitimize their status."
The WSJ has the story:
SEC Proposes Rules That Would Squeeze Stock-Market Middlemen. Agency is formally considering biggest overhaul of stock-market structure since mid-2000s By Paul Kiernan and Alexander Osipovich
"The Securities and Exchange Commission voted Wednesday to advance the biggest changes to U.S. stock-market rules since the mid-2000s, aiming to give small investors better prices on their trades and reduce some advantages enjoyed by high-speed trading firms.... Voting to advance the rules opens them to public comment until at least March 31 before the agency can decide whether to finalize them.
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"The broad idea motivating the proposals is to use greater competition for investors’ orders to deliver better prices, while stepping up regulations of the firms that profit from handling retail stock trades.
...
"The centerpiece of the SEC’s plans is a proposal for brokers to send many small-investor stock orders into auctions. This would enable a mix of high-speed traders and institutional investors such as hedge funds or pension funds to compete to fill the orders, with the idea that investors would get better prices as a result—higher prices if they are selling shares, or lower prices if they are buying.
"The auctions would apply to so-called marketable orders—in which investors buy or sell stocks at the currently available price—less than $200,000 in size and placed by investors who average fewer than 40 trades a day. They would be required to last between one-tenth and three-tenths of a second, roughly the duration of a blink of an eye, and would likely be run by exchanges.
Requiring such auctions would be a big change. The SEC says brokers send more than 90% of marketable orders to wholesalers. Unlike exchanges, which display price quotes publicly and allow a variety of market players to attempt to fill orders, wholesalers trade directly against the incoming retail flow, an arrangement that effectively prevents other market players such as institutional investors from interacting with individual investors’ orders."
HT: Eric Budish
Here's the latest report from HIAS on matching Ukrainian refugees to hosts in the U.S.
How an Innovative Algorithm Helps Ukrainian Refugees Find New Homes By Brian Zumhagen
"Odessa residents Max and Yuna* fled Ukraine on the day the Russian invasion began, February 24, 2022. It took them 7 days to reach the Polish border.
"The couple, both in their early 20s, spent the next several months in Poland. In September, they started applying for relocation to the United States with the help of HIAS. But unlike most refugees, Max and Yuna were among the first to use a new system that allowed them to list their preferences about where to be resettled, and any special needs they might have — thanks to a matching algorithm known as RUTH, which stands for Refugees Uniting Through HIAS. (The name was also inspired by the biblical Book of Ruth, which tells the story of how Ruth is herself welcomed as a foreigner).
...
"Back in Poland, HIAS Relocation Officer Denis Ruksha said some of the refugees from Ukraine he works with are relocated through European Welcome Circles, while others are resettled through circles in the United States. For those heading to the U.S., Ruksha has been using the RUTH platform for the last 3 months, entering beneficiaries’ preferences about where they would like to be relocated, along with other information. “It allows people to mention almost everything they think is relevant,” he said. In the U.S., volunteers in HIAS Welcome Circles can, in turn, enter their own preferences, such as the number of people they can host.
...
"RUTH isn’t the first computer system with a human name that HIAS has used to make its resettlement work easier and more effective. In 2018, the organization worked with partners to create matching software named after the first immigrant registered at Ellis Island in 1892. “Annie MOORE” (Matching and Outcome Optimization for Refugee Empowerment) used past employment data to direct refugees to locations where they would have the greatest chance of finding work.
"But where Annie focused on optimizing estimated employment outcomes, RUTH makes the relocation process faster and more transparent, according to the new platform’s developers. “This is the first time ever that preferences of refugees and priorities of hosts have been systematically used in the resettlement process,” said Andrew Trapp, associate professor of operations and industrial engineering at Worcester Polytechnic Institute.
"His colleague, Alexander Teytelboym, associate professor of economics at the University of Oxford, put it this way: “We think people are more likely to thrive in places where they prefer to live. Citizens are given a choice about almost anything of such consequence — so why shouldn’t refugees?”
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Here are my previous posts on HIAS and refugee resettlement
Vaccine development and distribution during the Covid pandemic has had some notable successes and some significant shortcomings.
Here's the latest issue of the Oxford Review of Economic Policy, which has collected articles by economists concerning some of those successes and failures and their lessons for future pandemics.
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