Friday, February 10, 2023

Human evolution in the last 12,000 years, in PNAS

My loose impression is that, not so long ago, scholars of human evolution discounted recent changes in the human genome, pointing out that maybe the frequency of lactose intolerance had been altered by the domestication of cattle, goats, and sheep, but suggesting that recent changes (i.e. since the invention of agriculture) were rare. This may have been an anti-racism perspective, or it may be that new data have changed this view, but indeed it seems to have changed.

Gene changes in recent milennia offer a window on how human patterns of interaction, regarding food acquisition and preparation, and communal living, may even cause changes in human biology.  

Here's a special feature on the subject, at the PNAS:

Special Feature: The Past 12,000 Years of Behavior, Adaptation, and Evolution Shaped Who We Are Today

"The authors of this Special Feature focus on challenges pertaining to dietary and nutritional quality and adequacy, resource inequality, interpersonal conflict and warfare, climate change, population trends, demographic transitions, migration, mobility, infectious disease and the rise of novel pathogens, and the transformative circumstances of human biology over the last 12,000 years.

Thursday, February 9, 2023

Ticketmaster and the secondary market for tickets, by Budish and Bhave

 Here's a still-timely paper that was a work in progress for quite a while.

Primary-Market Auctions for Event Tickets: Eliminating the Rents of “Bob the Broker”? By Eric Budish and Aditya Bhave, American Economic Journal: Microeconomics 2023, 15(1): 142–170 https://doi.org/10.1257/mic.20180230 

Abstract: "Economists have long been puzzled by event-ticket underpricing: underpricing reduces revenue for the performer and encourages socially wasteful rent-seeking by ticket brokers. What about using an auction? This paper studies the introduction of auctions into this market by Ticketmaster in the mid-2000s. By combining primary-market auction data from Ticketmaster with secondary-market resale value data from eBay, we show that Ticketmaster’s auctions “worked”: they substantially improved price discovery, roughly doubled performer revenues, and, on average, nearly eliminated the potential arbitrage profits associated with underpriced tickets. We conclude by discussing why, nevertheless, the auctions failed to take off."

From the conclusions:

"over the decade that has passed since the time of the data, rather than coming into more widespread use, primary-market auctions for event tickets instead disappeared. LexisNexis searches suggest that TM auctions were in use from their introduction in 2003 through around 2011, with a peak in around 2005–2008 but that with limited exceptions, they have not been used since.33

"We conclude by speculating as to why the auctions failed to take off. As discussed in the introduction, economic theory suggests that there are two basic choices for how to eliminate the rents of and rent-seeking by Bob the Broker: ban resale or set a market-clearing price. While auctions are no longer in use, what has at least partly taken off is using available data, including historical resale values, to set fixed prices in the primary market that more accurately approximate market clearing.

...

"We conjecture that the popularity of this practice relative to auctions partly reflects the simplicity and convenience for fans of posted prices relative to auctions, as has been documented more widely by Einav et al. (2018) and partly reflects a harder-to-model “repugnance” cost of ticket auctions (Roth 2007). 

...

"Setting market-clearing prices and banning resale are two ways to modify the primary market to eliminate Bob the Broker’s rents. TM has also aggressively expanded into the secondary market, acquiring TicketsNow for $265 million in 2008 (as well as UK-based Get Me In! for an undisclosed amount); entering into secondary-market partnerships with the National Basketball Association, National Hockey League, and National Football League (Major League Baseball has a partnership with StubHub); and most recently launching a secondary market within ticketmaster.com called Fan-to-Fan Resale that lists available primary-market tickets alongside secondary-market tickets.38 This business exploits TM’s unique ability, for events where it manages the primary market, to verify the authenticity of tickets in the secondary market. With transaction fees of about 30–40 percent in the largest secondary-market venues (Budish 2019)—of the full resale value, not of just the markup versus the fixed price—perhaps eliminating the rents of Bob the Broker is less profitable than taking a cut."


Wednesday, February 8, 2023

Song of the year Grammy award for organ donation: Bonnie Raitt - Just Like That

Stephanie Wang alerts me to the surprising fact that this year's Grammy Award for Song of the Year is Bonnie Raitt's song, Just Like That, about organ donation.  You can listen below (have some tissues handy):




CNN has the story: 
"Raitt’s winning song, “Just Like That,” is about a woman visited by a man who is only alive because of the heart he received – a heart that had belonged to the woman’s son.

“I was so inspired for this song by the incredible story of the love and the grace and the generosity of someone that donates their beloved’s organs to help another person live and this story was so simple and so beautiful for these times,” Raitt explained in her acceptance speech.

Tuesday, February 7, 2023

Social media advertising and COVID vaccination, in PNAS

 Vaccine rollout is different than allocating other (initially) scarce goods because it involves overcoming vaccine hesitancy.  Here's a meta-analysis which concludes that advertising was helpful and cost effective.

Athey, Susan, Kristen Grabarz, Michael Luca, and Nils Wernerfelt. "Digital public health interventions at scale: The impact of social media advertising on beliefs and outcomes related to COVID vaccines." Proceedings of the National Academy of Sciences 120, no. 5 (2023): e2208110120.

Abstract: Public health organizations increasingly use social media advertising campaigns in pursuit of public health goals. In this paper, we evaluate the impact of about $40 million of social media advertisements that were run and experimentally tested on Facebook and Instagram, aimed at increasing COVID-19 vaccination rates in the first year of the vaccine roll-out. The 819 randomized experiments in our sample were run by 174 different public health organizations and collectively reached 2.1 billion individuals in 15 languages. We find that these campaigns are, on average, effective at influencing self-reported beliefs—shifting opinions close to 1% at baseline with a cost per influenced person of about $3.41. Combining this result with an estimate of the relationship between survey outcomes and vaccination rates derived from observational data yields an estimated cost per additional vaccination of about $5.68. There is further evidence that campaigns are especially effective at influencing users’ knowledge of how to get vaccines. Our results represent, to the best of our knowledge, the largest set of online public health interventions analyzed to date.

Monday, February 6, 2023

Obstacles facing liver exchange

 Liver exchange is different than kidney exchange in a number of important dimensions, some of which will present obstacles that need to be overcome in different ways. (Although it looks like in liver exchange the donors will travel to the recipients instead of having the organs shipped, as is now mostly done in U.S. kidney exchange.  That's actually how kidney exchange worked when it began) Here's a recent article from Medscape:

Can a Nationwide Liver Paired Donation Program Work?  by Lucy Hicks

"To expand the number of living liver donations in the United States, the United Network for Organ Sharing (UNOS) has launched the first national paired liver donation pilot program in the United States.

...

"In 2020, 1095 people died while waiting for a liver transplant

...

"Paired kidney donation programs have been running since 2002, but paired liver donation is relatively new. Since the first US living-donor liver transplant in 1989, the procedure has become safer and is a viable alternative to deceased liver donation. A growing number of living donor programs are popping up at transplant centers across the country.

"Still, living-donor liver donation makes up a small percentage of the liver transplants that are performed every year. In 2022, 603 living-donor liver transplants were performed in the United States, compared to 8925 liver transplants from deceased donors

...

"There are several notable differences between living donor kidney transplants and living donor liver transplants. For example, living donor liver transplant is a more complicated surgery and poses greater risk to the donor. According to the OPTN 2020 Annual Report, from 2015–2019, the rehospitalization rate for living liver donors was twice that of living kidney donors up to 6 weeks after transplant (4.7% vs 2.4%). One year post transplant, the cumulative rehospitalization rate was 11.0% for living liver donors and 4.8% for living kidney donors.

"The risk of dying because of living donation is also higher for liver donors compared to kidney donors. The National Kidney Association states that the odds of dying during kidney donation are about 3 in 100,000, while estimates for risk of death for living liver donors range from 1 in 500 to 1 in 1000. But some of these estimates are from 10 or more years ago, and outcomes have likely improved

...

"In addition to a more complex surgery, surgeons also have a smaller time window in which to transplant a liver than than they do to transplant a kidney. A kidney can remain viable in cold storage for 24–36 hours, and it can be transported via commercial airlines cross country. Livers have to be transplanted within 8–12 hours, according to the OPTN website. For living donation, the graft needs to be transplanted within about 4 hours, Samstein noted; this poses a logistical challenge for a national organ paired donation program.

"We worked around that with the idea that we would move the donor rather than the organ," he said. The program will require a donor (and a support person) to travel to the recipient's transplant center where the surgery will be performed. While 3 of the 15 pilot paired donation transplant centers are in New York City, the other programs are scattered across the country, meaning a donor may have to fly to a different city to undergo surgery.

"Including the preoperative evaluation, meeting the surgical team, the surgery itself, and follow-up, the donor could stay for about a month. The program offers up to $10,000 of financial assistance for travel expenses (for both the donor and support person), as well as lost wages and dependent care (for the donor only). Health insurance coverage will also be provided by the pilot program, in partnership with the American Foundation for Donation and Transplant.

...

"The 1-year pilot program is set to begin when the program conducts its first match run — an algorithm will help match pairs who are enrolled in the program. About five to seven enrolled pairs would be ideal for the first match run, a UNOS spokesperson said. It is possible that the 1-year pilot program could run without performing any paired transplants, but that's unlikely if multiple pairs are enrolled in the system, the spokesperson said. At the time of this story's publication, the one enrolled pair are a mother and daughter who are registered at the UCHealth Transplant Center in Colorado."

Sunday, February 5, 2023

Advice on dealing with exploding offers in the Economics job market

 The market for new Economics Ph.D.s is in flux, with interviews this year being conducted remotely by Zoom rather than in person at the annual January conference. (Zoom interviews were a Covid innovation that seems likely to stay--mostly because remote interviews seemed to work well.)  But issues of timing can be delicate, and there's some concern that, now that initial interviews aren't being synchonized with the annual meetings, we're seeing more early interviews, flyouts (subsequent in-person, on campus interviews) and offers than in previous years, including more offers that require replies very quickly--exploding offers.  Exploding offers cause difficulties to those who receive them, and they contribute to market-wide difficulties, as they can cause the market to move earlier from year to year, i.e. to unravel into very early offers at diffuse times, so that the market loses thickness.

So...I wasn't too surprised to get an email this week from a colleague who has a student on the market who presently has two exploding offers, each with a one-week deadline.  My colleague writes that his student  presently has flyouts scheduled with other schools through February, and so won't even have visited them by the time his exploding offers expire. "He would much prefer an offer from several of them to these 2 current offers--but I have no idea what is the likelihood of getting offers from them."

He asks me "Does any entity such as the ASSA, Stanford, etc. have a policy that I can mention to these schools? "  And he asks for my advice.  I don't have great advice, but here's my slightly redacted reply:

"The AEA doesn’t have a good policy on this, but the AFA does: see my blog post here

Tuesday, August 2, 2022 American Finance Association guidelines to prevent unravelling of the job market  (it says) “the AFA promotes the following professional norm: If a job candidate receives and accepts a coercive exploding offer (i.e., one that expires before February 20), the AFA does not consider such an acceptance to be binding.”

 "That said, talking to the schools that have issued coercive exploding offers is a good idea, and it may or may not help.  I think there are three main reasons they might make exploding offers.

  • 1.       Pure evil: they think your student might get a better offer if they wait, and want to capture him before that.
  • 2.       Fear that their other candidates will disappear: they may have a second choice candidate who already has an exploding offer, in which case they may be able to tell you when that offer explodes.  But maybe their fear is less focused than that, in which case you might get them to extend the offer on the understanding that they can make it explode later.
  • 3.       Boilerplate: they may have just copy-pasted from some template that had a short fuse offer. In this case there’s a good chance they’ll relax the drop dead date.

 "I’ve encountered other reasons as well. In the 2008 financial crisis some of our students got exploding offers, and when I called one school to inquire, was told that their dean wouldn’t allow them to schedule any more flyouts until/unless they’d been rejected by our student.

 "There are labor markets that suffer a great deal from exploding offers (e.g. private equity right now, among others).  But it’s still not the norm in economics, so I think you have a good chance of getting some more time by asking for it."


Saturday, February 4, 2023

Unraveling of the private equity labor market, continued (and continuing)

 Here's some news and history on the

Private Equity On-Cycle Recruiting Timeline

by Matt Ting (Peak Frameworks)

"The sheer absurdity of the private equity recruiting process is perhaps best illustrated by the recruiting timeline.

"In recent years, private equity recruiting has kicked off within months of people graduating. Private equity firms commonly interview and hire people that have fewer than 6 months of work experience. And the thing is, private equity firms are hiring people who won’t actually start their jobs for another 2 years.



"Over a decade ago, recruiting occurred only 1 year in advance. This gave analysts much more time to do actual deals, technically prepare, and thoughtfully decide if they wanted to recruit for private equity.

"Every single year, the recruiting timeline inches forward by a month or so. There was a brief stretch for the 2012 – 2016 associate classes where the start time held relatively constant at around 1.5 years in advance.

"Over the past five years, the recruiting timeline has consistently moved up a month or two at a time. Every single year, many firms get caught off-guard or unprepared because of how accelerated things have become. It’s at the point where it seems like there’s no further it can move forward.

"The only time over the last 15 years that recruiting has moved backwards in time was during the Great Recession (recruiting during July 2009). And even then, recruiting only moved back by a couple of months."

HT: Mike Ostrovsky

Friday, February 3, 2023

Selling flavored cigarettes after California's ban

 It's hard to regulate tobacco. The NY Times brings us up to date on California's ban on flavored tobacco products.

R.J. Reynolds Pivots to New Cigarette Pitches as Flavor Ban Takes Effect. Now that California’s tobacco prohibitions are in place, some Camel and Newport items are billed as newly “fresh” or “crisp” non-menthol versions. By Christina Jewett and Emily Baumgaertner

"R.J. Reynolds has wasted no time since California’s ban on flavored tobacco went into effect in late December. “California, We’ve Got You Covered,” the company declared in bold letters on a flier mailed to its cigarette customers.

"The law prohibits flavors, odors or “tastes” in tobacco products, including menthol cigarettes. But antismoking experts argue that R.J. Reynolds, the maker of Camel and Newport brands, is trying to circumvent the ban by luring smokers with a suite of what it says are new non-menthol versions offering “a taste that satisfies the senses” and “a new fresh twist.”

"The campaign is viewed by critics as a provocation of California authorities who are supposed to enforce the ban, which includes a provision outlawing packaging or claims that suggest a product has a flavor. The Food and Drug Administration also is moving forward with a national plan to take menthol cigarettes off the market.

...

"Dr. Robert Jackler, a professor at Stanford Medicine who provided the ads to The New York Times, called the new marketing “outrageous.”

“The thing that surprises me is there’s no camouflage,” said Dr. Jackler, who received the mailers along with staff members of Stanford’s program on tobacco advertising. “They’re saying, ‘This is our menthol replacement. And by the way — wink, wink — it is not really menthol.’”

...

"Worldwide, tobacco companies have discovered loopholes to bans on menthol or flavored tobacco, studies show. In Canada, flavor cards and additive drops have been used to supplement unflavored products. In Denmark, smokers now have access to menthol sprays, capsules and tubes."

***********



Earlier:

Tuesday, December 27, 2022

Thursday, February 2, 2023

Legal Frontiers for Safeguarding Reproductive Freedoms, in JAMA

 We can expect long legal battles to follow the repeal of Roe v. Wade.  Here's a survey of the battlefield in JAMA.

New Legal Frontiers for Safeguarding Reproductive Freedoms by Rebecca B. Reingold, JD; Lawrence O. Gostin, JD, JAMA. Published online January 30, 2023. doi:10.1001/jama.2023.1004

"In Dobbs v Jackson Women’s Health Organization, the Supreme Court overturned the landmark ruling, thus eliminating a national right to abortion before viability. Key federal strategies to address this ruling include expanding access to medication abortions and emergency abortion services. Federal conscience protections for health workers balance nondiscriminatory access to abortion services. Ballot initiatives and courts are seeking to protect reproductive rights under state constitutions. At stake is whether pregnant people can access essential services, with significant consequences for autonomy, dignity, health, and emotional well-being.

...

"In January 2023, the US Food and Drug Administration (FDA) modified its Risk Evaluation and Mitigation Strategy (REMS) to allow retail pharmacies to dispense mifepristone.2 Previously, mifepristone could be dispensed only in certain clinics, medical offices, and hospitals.

...

"In December 2022, the Department of Justice (DOJ) at the request of the US Postal Service (USPS) issued guidance clarifying the lawfulness of sending abortion medications through the USPS.3 An 1873 federal law (the Comstack Act) prohibits mailing any “article or thing designed, adapted, or intended for producing abortion.”4 The DOJ determined that the Comstack Act does not prohibit mailing, delivery, or receipt by mail of mifepristone or misoprostol because the sender cannot know if the drug will be used unlawfully.

...

"The Emergency Medical Treatment and Labor Act (EMTALA) requires hospitals that receive Medicare funds to provide stabilizing treatment to patients experiencing a medical emergency.6 Urgent medical treatment should extend both to saving life and preserving health. In July 2022, the Centers for Medicare & Medicaid Services (CMS) issued guidance stating that EMTALA requires abortion services wherever necessary to stabilize a pregnant patient experiencing an “emergency medical condition.”6 The CMS concluded that EMTALA preempts contrary state laws banning or restricting abortions under urgent circumstances.

...

"In December 2022, the Department of Health and Human Services (HHS) Office for Civil Rights proposed a new rule for health workers and entities that refuse to provide abortion or other services for religious or moral reasons. ... The Biden administration’s proposed rule would strike a balance between “safeguarding conscience rights and protecting access to health care.”8 Marginalized, disadvantaged, and underserved communities, including LGBTQ+ patients, persons with disabilities, and persons living with HIV, are disproportionately affected by conscience protections. The proposed rule should better protect patients’ autonomy, health, and dignity, while also respecting clinicians’ moral and religious convictions."

Wednesday, February 1, 2023

Donate blood or organs to pay a traffic fine or shorten a prison term?

I spend a lot of my time thinking and writing about repugnant transactions and controversial markets, and some of that intersects with my work on blood and organ donation and transplantation (particularly on the controversial issue of compensation for donors, and how that might intersect with varieties of coercion). But today's post is about two proposals that mix all these things together. (My guess is that many people will find them differently repugnant: think of them as a quick test of your own views.)

In Argentina, a municipal judge proposes blood donation to pay traffic fines, and in Massachusetts several legislators co-sponsor a bill to allow bone marrow (blood stem cell) donation or organ donation to reduce prison sentences.

First, blood donation and traffic fines:

 Mario Macis points me to this story in La Nacion, about a city in the Argentine province of Salta:

En una ciudad de Salta las multas de tránsito se pueden pagar con una donación de sangre  [In a city of Salta, traffic fines can be paid with a blood donation]  (English from Google Translate)

"In the city of Tartagal, Salta, it is possible to pay a traffic ticket with a blood donation . The measure, taken two months ago, generates both support and questioning.

...

"The judge of the Court of Misdemeanors of the Municipality of Tartagal, Farid Obeid , proposed in a ruling last August that those who had traffic fines could pay them with their own blood donation or from third parties on behalf of the offenders.

"It was then determined that donations be made in hospitals, voluntarily and only once; that is to say that repeat offenders cannot opt ​​for blood donation.

...

"The ruling received support and criticism, the latter basically from the health sector. Oscar Torres, president of the Argentine Association of Hemotherapy, Immunohematology and Cellular Therapy , sent a letter to the Deliberative Council of Tartagal indicating that the measure removes the "spirit of solidarity and altruism from blood donation

Here's a related story about the ongoing debate (also using Google translate):

Controversy over an unusual municipal project: they claim that fines can be paid with blood. "This controversial project was presented to the Deliberative Council of Tartagal, and criticism has already begun"

***********

And here's the new bill proposed in Massachusetts (don't hold your breath waiting for it to be passed into law). It's in English, so the phrase about the necessary "amount of bone marrow and organ(s) donated to earn one’s sentence to be commuted" isn't a translation error; I think it's just awkward (i.e. not meant to be chilling). (But the discussion of donated "organ(s)" makes me think of Kazuo Ishiguro's novel "Never Let Me Go"). 

Bill HD.3822, 193rd (Current), An Act to establish the Massachusetts incarcerated individual bone marrow and organ donation program

"Section 170. (a) The Commissioner of the Department of Corrections shall establish a Bone Marrow and Organ Donation Program within the Department of Correction and a Bone Marrow and Organ Donation Committee. The Bone Marrow and Organ Donation Program shall allow eligible incarcerated individuals to gain not less than 60 and not more than 365 day reduction in the length of their committed sentence in Department of Corrections facilities, or House of Correction facilities if they are serving a Department of Correction sentence in a House of Corrections facility, on the condition that the incarcerated individual has donated bone marrow or organ(s)

...

"The Bone Marrow and Organ Donation Committee shall also be responsible for promulgating standards of eligibility for incarcerated individuals to participate and the amount of bone marrow and organ(s) donated to earn one’s sentence to be commuted. Annual reports including actual amounts of bone marrow and organ(s) donated, and the estimated life-savings associated with said donations, are to be filed with the Executive and Legislative branches of the Commonwealth. All costs associated with the Bone Marrow and Organ Donation Program will be done by the benefiting institutions of the program and their affiliates-not by the Department of Correction. There shall be no commissions or monetary payments to be made to the Department of Correction for bone marrow donated by incarcerated individuals."


Simultaneous HT to Ron Shorrer, Kim Krawiec, Akhil Vohra

Tuesday, January 31, 2023

Donating blood while gay

 The Washington Post brings us up to date:

FDA to ease blood donation ban on gay men, allow monogamous to give. By Laurie McGinley, Teddy Amenabar and  Fenit Nirappil 

"Gay and bisexual men in monogamous relationships will no longer be forced to abstain from sex to donate blood under federal guidelines to be proposed in coming days, ending a vestige of the earliest days of the AIDS crisis.

"The planned relaxation of restrictions by the Food and Drug Administration follows years of pressure by blood banks, the American Medical Association and LGBT rights organizations to abandon rules some experts say are outdated, homophobic and ineffective at keeping the nation’s blood supply safe."

"The new approach eliminates rules that target men who have sex with men and instead focuses on sexual behaviors by people, regardless of gender, that pose a higher risk of contracting and transmitting HIV"

Monday, January 30, 2023

Tonya Ingram (1991-2022), health activist, died while waiting for a kidney

 Tonya Ingram, a poet and health activist who testified in Congress about the long waiting list for kidney transplants, died last month while still waiting.  Saturday's New York Times had a moving column about her activism, her struggle and her long wait.

Tonya Ingram Feared the Organ Donation System Would Kill Her. It Did. By Kendall Ciesemier (Ms. Ciesemier is a writer, a producer and an organ recipient.) Jan. 28, 2023

Here's her obit in the LA Times:

Tonya Ingram, an inspiring L.A. poet and ‘lupus warrior,’ died waiting for a kidney by Jireh Deng, JAN. 23, 2023

Market design isn't only about trying to allocate scarce resources effectively, it's also about working to make them less scarce.

Sunday, January 29, 2023

Paul David (1935-2023)

 My Stanford colleague Paul David has died. He was an exceptional, iconic economic historian.

Gavin Wright has written this obit:

Professor Paul David died at the age of 87

"Always an economic historian, Paul soon extended his horizons in diverse and seemingly disparate ways.  He became a strong advocate of the view that historical research should be fundamental to the economics discipline; in brief; “history matters.”  The essence of the argument was captured by Paul’s incisive account of the persistence of the QWERTY typewriter keyboard despite its technical disadvantages, one of the most cited articles in all of economics (AER 1985).  “History Matters” is the title of a festschrift presented by a group of Paul’s former students in 2004, in which the editors write: “No scholar has more forcefully and influentially argued the case for making economics a truly historical social science – one that, like evolutionary biology, gives past events a central role in understanding the present.” 

"A continuing focus throughout Paul’s career was the diffusion of new technologies.  An important early paper considered the adoption of the mechanical reaper in the American Midwest.  Invention occurred in the 1830s, yet the first wave of adoption occurred only in the 1850s.  The twenty-year delay, according to Paul, was explained by the fact that a minimum scale was required to cover the fixed costs of purchasing the reaper.  Only when farms size passed this “threshold” did mechanization make economic sense.  Specialists have debated the specifics ever since, but the basic form of Paul’s diffusion model has been highly influential.  In many respects it formalized the accounts of delayed diffusion presented by our late colleague Nate Rosenberg, and thus became something of a “Stanford school” of thought in this area.  Scrolling forward to 1990, the era of the “Solow paradox,” Paul offered an analogy between the delayed productivity effects of computer technology and a similar lag in the impact of electrification between the 1880s and the 1920s.  With the IT-driven productivity surge of the late 1990s, this article also attained iconic status (AER 1990)."

Saturday, January 28, 2023

Signaling in the markets for new doctors

 Signaling of interest is catching on in medical labor markets for residents and fellows.

Here's some material from Thalamus (which describes itself as "Complete GME interview management solution for applicants & programs. Easy, secure, and automated interview scheduling to optimize in-person & virtual recruitment.")

The Ultimate Guide to Preference Signaling for Medical Residency Applicants and Programs 2022-2023.

It all seems to have started with the signaling mechanism we use in Economics.

From Part 1: 

"The Emergence of Preference Signaling:
Preference signaling was first implemented in 2006, as part of the recruitment process for economics graduate students administered through the American Economics Association (AEA). Since then, there have been several useful studies analyzing this process by leading economists at institutions including Harvard and Stanford. These include “Preference Signaling in Matching Markets” and “The Job Market for New Economists: A Market Design Perspective.”

"Of note, one of the authors on the latter article is Dr. Alvin E. Roth, who won the Nobel Prize in Economics for proving certain key attributes of the matching algorithm that is used today by the National Resident Matching Program (NRMP), where Dr. Roth currently serves as a board member. This article has been cited in papers throughout GME that examine preference signaling in specialties including Otolaryngology and Orthopaedic Surgery."
********
Earlier:


Friday, January 27, 2023

Liver exchange pilot program at UNOS

 In another step for liver exchange, here's the announcement from UNOS, which recently registered its first patient-donor pair:

UNOS launches first national liver paired donation pilot program

"An innovative approach to matching livers to patients in need aims to increase lifesaving transplants by expanding the number of living liver donations. United Network for Organ Sharing (UNOS) has launched the UNOS Liver Paired Donation (LPD) pilot program, the first nation-wide initiative facilitating liver paired donation matches; the project is led by UNOS Labs in collaboration with transplant and donation professionals from across the country.

"More than 10,000 people are currently waiting for a liver transplant, and increasing paired donation can make a difference. “The community recognized a critical need,” said Ruthanne Leishman, who manages UNOS paired donation programs. “While the idea of swapping livers is new, transplant programs have successfully been swapping kidneys since 2002.” Leishman was part of the UNOS team that initiated the Organ Procurement and Transplantation Network (OPTN) Kidney Paired Donation (KPD) pilot program in 2010, at a time when there were fewer living liver donor transplants. Since that time, living liver donations have become safer and more viable, contributing to the development of living liver donation programs throughout the country. There were 603 living liver donor transplants in the United States in 2022.

"The UNOS LPD pilot program includes 15 experienced transplant programs across the country who have together performed hundreds of living liver transplants over the years. “UNOS Labs has collaborated with a team of some of the most respected transplant professionals in the country. Working with this high caliber of transplant professionals has helped UNOS build a strong program that will increase living donor transplants,” said Leishman.

"While some transplant hospitals have swapped livers within their own or neighboring hospitals, the UNOS LPD program now makes it possible to swap livers across the country. The larger pool of potential living donors means candidates can have increased access to living liver donations, and transplant hospitals have the opportunity to grow their living transplants programs through collaboration.

"The first donor and recipient pair registered in the program are at UCHealth Transplant Center in Aurora, Colo., and are waiting for a match.

“The UNOS LPD program has totally shifted our frame of mind,” says Jaime Cisek, Living Donor Coordinator at UC Health Transplant Center. “It used to be that if someone was incompatible because of their blood type, or there was a significant size discrepancy, then there was no point in working them up. Now, nobody is off the table. Now we’re able to consider that there is somebody out there who is compatible and make that swap.”

"The UNOS LPD program offers living liver donors assistance with both medical and non-medical expenses related to donation, such as travel expenses, lost wages and dependent care. This financial assistance was made possible through a partnership with the National Living Donor Assistance Center (NLDAC) and a generous gift from living liver transplant recipient and UNOS financial supporter David Landes. "

Thursday, January 26, 2023

Blasphemy in Pakistan

 How to strengthen a ban that already allows the death penalty for repugnant speech?  The NYT has the story:

Pakistan Strengthens Already Harsh Laws Against Blasphemy. Insulting Islam or its founder is already a capital offense, but now those who insult people connected to the Prophet Muhammad could get prison time. By Salman Masood

"Pakistan’s blasphemy laws, which can already mean death for those deemed to have insulted Islam or the Prophet Muhammad, can now also be used to punish anyone convicted of insulting people who were connected to him.

"The move this week by Parliament to further strengthen the nation’s strict blasphemy laws, which are often used to settle personal scores or persecute minorities, has raised concerns among rights activists about the prospect of an increase in such persecution, particularly of religious minorities, including Christians.

...

"Those convicted of insulting the Prophet Muhammad’s wives, companions or close relatives will now face 10 years in prison, a sentence that can be extended to life, along with a fine of 1 million rupees, roughly $4,500. It also makes the charge of blasphemy an offense for which bail is not possible.

...

"Taking a stand on the issue can also be dangerous, as the assassination of two senior politicians more than a decade ago made clear. In 2011, Salmaan Taseer, the governor of Punjab Province, was fatally shot by one of his own bodyguards. Mr. Taseer had been an outspoken opponent of the blasphemy laws and had campaigned for the release of Asia Bibi, a Christian convicted of insulting the Prophet Muhammad. Shahbaz Bhatti, a federal minister and a Christian who had also opposed the death sentence imposed on Ms. Bibi, was fatally shot the same year."

Wednesday, January 25, 2023

Academic authorship for sale

 Here's a news story in Nature:

Multimillion-dollar trade in paper authorships alarms publishers. Journals have begun retracting publications with suspicious links to sites trading in author positions.  by Holly Else

"Research-integrity sleuths have uncovered hundreds of online advertisements that offer the chance to buy authorship on research papers to be published in reputable journals.

"Publishers are investigating the claims, and have retracted dozens of articles over suspicions that people have paid to be named as authors, despite not participating in the research. Integrity specialists warn that the problem is growing, and say that other retractions are likely to follow.

...

"Most of the adverts are posted on social-media sites including Facebook and Telegram, as well as the websites of companies that claim to offer academic publishing services. They often include the title of the paper, the journal it will be published in, the year of publication and the position of authorship slots available for purchase. Prices range from hundreds to thousands of US dollars depending on the research area and the journal’s prestige."

*****

Here is the underlying working paper, on arxiv,  to which the story refers:

Publication and collaboration anomalies in academic papers originating from a paper mill: evidence from a Russia-based paper mill  by Anna Abalkina

This study attempts to detect papers originating from the Russia-based paper mill International publisher LLC. A total of 1009 offers published during 2019-2021 on the this http URL website were analysed. The study allowed us to identify at least 434 papers that are potentially linked to the paper mill including one preprint, a duplication paper and 15 republications of papers erroneously published in hijacked journals. Evidence of suspicious provenance from the paper mill is provided: matches in title, number of coauthorship slots, year of publication, country of the journal, country of a coauthorship slot and similarities of abstracts. These problematic papers are coauthored by scholars associated with at least 39 countries and submitted both to predatory and reputable journals. This study also demonstrates collaboration anomalies and the phenomenon of suspicious collaboration in questionable papers and examines the predictors of the Russia-based paper mill. The value of coauthorship slots offered by International Publisher LLC in 2019-2021 is estimated at $6.5 million. Since the study analysed a particular paper mill, it is likely that the number of papers with forged authorship is much higher.


Tuesday, January 24, 2023

"Financial incentives for vaccination do not have negative unintended consequences," in Nature

 Here's a recent article in Nature whose title effectively summarizes its conclusions, and brings some evidence from RCTs to bear on the issue of whether financial incentives corrupt innate values:

Florian H. Schneider, Pol Campos-Mercade, Stephan Meier, Devin Pope, Erik Wengström & Armando N. Meier, "Financial incentives for vaccination do not have negative unintended consequences. Nature (2023). https://doi.org/10.1038/s41586-022-05512-4

Abstract: Financial incentives to encourage healthy and prosocial behaviours often trigger initial behavioural change1,2,3,4,5,6,7,8,9,10,11, but a large academic literature warns against using them12,13,14,15,16. Critics warn that financial incentives can crowd out prosocial motivations and reduce perceived safety and trust, thereby reducing healthy behaviours when no payments are offered and eroding morals more generally17,18,19,20,21,22,23,24. Here we report findings from a large-scale, pre-registered study in Sweden that causally measures the unintended consequences of offering financial incentives for taking the first dose of a COVID-19 vaccine. We use a unique combination of random exposure to financial incentives, population-wide administrative vaccination records and rich survey data. We find no negative consequences of financial incentives; we can reject even small negative impacts of offering financial incentives on future vaccination uptake, morals, trust and perceived safety. In a complementary study, we find that informing US residents about the existence of state incentive programmes also has no negative consequences. Our findings inform not only the academic debate on financial incentives for behaviour change but also policy-makers who consider using financial incentives to change behaviour.


"We exploit a randomized controlled trial (RCT) in the context of financial incentives for COVID-19 vaccination (P.C.-M. et al., unpublished, and ref. 5). Participants were offered payments of 200 Swedish krona (SEK; about US $24 at the time) for taking a first dose of a COVID-19 vaccine, which increased first-dose uptake by 4 percentage points 30 days after the trial (uptake remained higher even 3 months later). The RCT setting is ideal in that it allows us to compare individuals who were randomly offered financial incentives for vaccination with individuals who were not offered any financial incentives. We combine the RCT data with new Swedish administrative records for second-dose uptake and with rich, individual-level survey data.

...

"We complement our evidence from Sweden with evidence on the effects of large-scale incentive programmes implemented by US state governments. In a pre-registered study in the USA (n = 3,062), participants randomly assigned to the incentives condition received detailed information about their state’s COVID-19 vaccine incentive programme, whereas participants in the control condition did not receive this information. Because most of the participants were unaware that their state offered incentives for vaccination, this experimental design overcomes the identification problems by creating random variation in perceived exposure to incentives. In line with the evidence from Sweden, we find no negative impacts of being informed about incentive programmes on the willingness of participants to take a further dose"

Monday, January 23, 2023

Incentives for deceased organ donation, in Asia

 Here's a discussion, in an Asian context, of providing incentives to families to consent to deceased donation.

Introducing Incentives and Reducing Disincentives in Enhancing Deceased Organ Donation and Transplantation by Kai Ming ChowMBChB⁎ Curie AhnMD† Ian DittmerMBChB‡ Derrick Kit-SingAuLMCHK§ IanCheungMBBS║ Yuk LunChengMBChB¶ Chak SingLau MBChB Deacons Tai-KongYeungMBBS║ Philip Kam-TaoLi MD Seminars in Nephrology,  Available online 27 December 2022

*Department of Medicine and Therapeutics, Carol and Richard Yu PD Research Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong

† Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea

‡Department of Renal Medicine, Auckland City Hospital, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand

§Centre for Bioethics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong

║Cluster Services Division, Hospital Authority, Kowloon, Hong Kong

¶Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong

#Department of Medicine, Queen Mary Hospital, University of Hong Kong, Pok Fu Lam, Hong Kong, China

Summary: Despite the effectiveness of solid organ transplantation, progress to close the gap between donor organs and demand remains slow. An organ shortage increases the waiting time for transplant and involves significant costs including patient morbidity and mortality. Against the background of a low deceased organ donation rate, this article discusses the option of introducing incentives and removing disincentives to deceased organ donation. Perspectives from ethics, general public opinion, and the health care profession are examined to ensure a comprehensive appraisal and illustrate different facets of opinion on this complex area. Special cultural and psychosocial considerations in Asia, including the family based consent model, are discussed.


This sentence caught my eye:

"After suggestion by Economics Nobel Laureate Alvin Roth for the community to unite to remove disincentives to kidney donation, the transplant community and academia have been having more discussion and analysis. That, in part, hinges on the estimates of the economic welfare gain for the society as a whole."

...

"PERSPECTIVES OF ASIAN SOCIETY

"It is widely recognized that deceased organ donation rates in Asian countries have been significantly lower than that in Western countries.

...

"No one disputes the social and cultural beliefs in the decision to donate organs. 

...

"An example of honoring the principles of reciprocity in incentivizing organ donor registrations is the organ allocation priority policy. Israel became the first country in 2008 to enact legislation incorporating such incentives based on individuals’ willingness to donate into their organ procurement system.26,42,43 The policy provides an incentive or motivation by the reciprocal altruistic dictum that “each partner helping the other while he helps himself,”42 granting priority on organ donor waiting lists to those individuals who registered as organ donors by signing a donor card for at least 3 years. Subsequent observations in Israel, as analyzed 5 years after introduction of the new policy, included an increase in the authorization rate of next of kin of unregistered donors, as well as a two-fold higher likelihood of next-of-kin authorization for donation when the deceased relative was a registered donor.44

"How does the concept of reciprocity apply for Asian societies? Will the results from Israel be replicated in Asia? Although social exchange theory should be a universal normal applicable to all human relationships, cultural influence or patterns might differ. Previous research on reciprocity across different cultural contexts, indeed, has shown that East Asians tend to reciprocate in kind and emphasize more on equity-based theory than Americans.45 Viewed through such a lens of “to give is to take,” it is relevant to quote another similar example in Taiwan, where incentives were provided to deceased organ donors’ families. In brief, after a person has become a deceased organ donor in Taiwan, up to three of his or her blood relatives will be granted priority to receive a deceased donor organ should they be on the waiting list for transplantation.46

"At the heart of the issue is the family based consent that is unique and vital, albeit not exclusive, in Confucian tradition within Chinese societies. It is important to note that organ donation is more often a family based consent process in Chinese culture than those “from a Western cultures”. As such, family priority right provided in the Israel or Chinese model would be more likely to motivate organ donation within a family based ethical culture.47 As in any discussion of culture's influence on organ donation decision, we must be mindful that East Asians tend to favor family centered decision making.

...

"If the concept of reimbursing funeral expenses for deceased organ donors is explored further then these four tenets are suggested as a guide: Tenet 1: the overarching principle is to appreciate and recognize the altruistic behavior of organ donors, and not the next of kin. Tenet 2: the second priority of reimbursing funeral expenses is to motivate the passive-positive public to sign up for organ donation. Tenet 3: the ultimate beneficiary from an incentive system is society, with an improved deceased organ donation rate. Government and charitable organizations, but not organ recipients, should be the source of payment. Tenet 4: as a token of expressing gratitude to the deceased organ donors, funeral expenses reimbursement preferably should be offered to those who have expressed the wish to donate (donor registration); they should have been provided the option to decline the offer."

Sunday, January 22, 2023

The trade in guns and drugs on the Mexico-US border

 It's well known that a lot of illegal drugs enter the U.S. over the border with Mexico.  Less well known in the U.S. is that a lot of guns cross illegally into Mexico over that border, destined for Mexican drug cartels.  

Here's a story from the Guardian:
How Texas’s gun laws allow Mexican cartels to arm themselves to the teeth by Sam Garcia.

"Despite Mexico’s well-documented high levels of violence, legally purchasing guns there is actually quite difficult. The nation of nearly 130 million people has a single store that can legally sell guns.

...

"Mexican foreign affairs ministry legal adviser Alejandro Celorio Alcántara estimates that half a million guns annually are purchased legally in the US and then brought into Mexico illegally. About 70% of guns seized in Mexico from 2014 to 2018 and submitted for tracing had originally come from the US, according to officials with the American bureau of alcohol, tobacco, firearms and explosives (ATF).

*******

Here's another report:

Dribs and Drabs: The Mechanics of Small Arms Trafficking from the United States

"Robust arms export licensing regimes are necessary but not sufficient for stopping small arms trafficking. Many of the traffickers studied did not apply for arms export licences or attempt to exploit licensing exemptions; they simply bypassed the licensing system entirely. At the same time, recent examples of attempted and successful diversion of authorized small arms exports highlight the continued need for rigorous licensing and post-shipment end-use monitoring.

"Arms trafficking from the United States goes well beyond gun-running to Mexico. Traffickers in the 159 cases studied shipped weapons, parts, ammunition, and accessories to at least 46 countries and foreign territories on six continents. Intended recipients of these items range from Honduran farm workers to a Finnish motorcycle gang 

"The illicit trade in parts and accessories for small arms is more significant than commonly assumed. Networks that traffic in firearms parts are among the most prolific and geographically expansive of the smuggling operations studied"


HT: Sarah Hirsch

Saturday, January 21, 2023

Post Roe (post Dobbs) legal efforts to secure rights established in previous Court decisions

 Since the Supreme Court ruling in Dobbs that overturned Roe and said that abortion was subject to regulation by each State, and not an individual right, there have been attempts in Washington to moderate some of its potential effects, particularly in light of Justice Thomas' opinion that the ruling could lead the way to rolling back other rights established by previous court rulings.

There have been some successes and some failures.

Here's a story from the Guardian about some new regulations and interpretations.

The US government just took two big steps on abortion. Will they matter? While the decisions cannot undo abortion bans in the 13 states they exist, it could make a huge difference where the right is protected  by Poppy Noor

"This week, the federal government announced two decisions designed to improve abortion access in the US. The first, a rule change made by the Food and Drug Administration, allows pharmacies to dispense mifepristone, one of the two drugs needed for a medication abortion. The second, an opinion drafted by the justice department, gives the US Postal Service the all clear to continue mailing abortion pills, even to states where abortion is severely restricted.

...

These decisions cannot undo abortion bans in the 13 states where they exist. While major pharmacies such as Walgreens and CVS have announced they will seek certification to dispense mifepristone, a prescription for it still will not be legal in states with a ban. Anyone distributing or taking abortion pills in banned states could still face severe consequences. And the justice department opinion will not protect anyone sending pills to a banned state from being prosecuted in that state, or anyone who takes the pills knowingly to induce an abortion from being investigated.

But in states where abortion is protected, both moves could make a big difference, advocates say.

Take California as an example, which recently expanded access for abortion care in its state constitution. Until now, abortion pills had to be dispensed by a doctor, an abortion clinic, or a mail order pharmacy. But even in California, many people live hundreds of miles away from an abortion clinic.

...

"It is unclear whether the FDA ruling will see pharmacies dispensing mifepristone in states with limits on abortion that fall short of total bans."

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

One of the concerns is that some states may declare fetuses to be persons, in a way that would extend their abortion bans to also include forms of assisted reproductive technology such as IVF, which create embryos to allow infertile couples start families.  An effort to protect IVF was introduced just before the close of the previous Congress, but it wasn't made into law, and the new Congress is likely to be less sympathetic.

Right to Build Families Act of 2022 (proposed by Senator Tammy Duckworth, but not enacted)

"A BILL To prohibit the limitation of access to assisted reproductive technology, and all medically necessary care surrounding such technology."

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Earlier:

Wednesday, December 14, 2022