Vertical Fiscal Imbalance, Economic Growth and Decentralization

Irrespective of the degree of tax and expenditure decentralization, every federation and unitary state face the problem of Vertical Fiscal Imbalance (VFI). The transfer dependency of subnational governments led them to substitute central transfers over their own revenue effort and this is historically evident in Pakistan. The contribution of provincial own revenues to the provincial expenditures is not much decent, which led to higher magnitude of VFIs. This paper is an empirical investigation of VFI, and its determinants. Based on a strongly balanced panel data at provincial (subnational) level from 1971 to 2021, we studied the effect of economic growth, tax decentralization, expenditure decentralization, and Eighteenth Amendment to the Constitution on VFIs. One of the key distinctions of this paper is modelling economic growth using per capita energy consumption which includes electricity, natural gas and set of petroleum products. Economic growth proxied through per capita energy consumption has negative association with VFI which means a corrective effect on VFI. Similarly, tax decentralization is also negatively associated with VFI, which obviously means corrective effect and less transfer dependency on federal government. To the contrary a positive association between expenditure decentralization and VFI is indicative that increase in government size/budget outlay are broadly financed through federal transfers thereby creating larger vertical fiscal imbalances. This also give policy prescription for future, that tax decentralization has disproportionality higher benefits compared to expenditure decentralization in terms of magnitude of VFIs. Based on different model specifications, we found that Eighteenth Amendment to the Constitution has both corrective and expansionary effect on VFIs

IMPACT OF REGIONAL WEALTH DISPARITIES ON CHILD SCHOOLING: A CASE OF PUNJAB, PAKISTAN

Este artigo tem como objetivo explorar o efeito da disparidade de riqueza entre os distritos de Punjab na matrícula escolar de crianças de 3 a 14 anos de idade no período de 2008, 2011, 2014. Este estudo utilizou o modelo probit e também usa o componente principal análise para criar um índice de disparidade de riqueza distrital para examinar como isso influencia a escolarização das crianças nas economias em desenvolvimento. As descobertas expõem que a probabilidade de matrícula escolar é influenciada negativamente pela disparidade de riqueza dos distritos nos três modelos, ou seja, para todas as crianças. Nas variáveis de controle, os domicílios que recebem remessas levam ao aumento da escolaridade das crianças. A educação dos pais aumenta a possibilidade de escolaridade nos três modelos. A educação da mãe afeta mais a matrícula infantil do que a educação da cabeça em todos os modelos. As crianças estavam menos dispostas a estudar no ano de 2007 para todos os três modelos. Os resultados sugerem que a diminuição da disparidade entre os distritos de Punjab deseja uma distribuição equivalente de fundos do governo de Punjab para os distritos. Pode aumentar o bem-estar da família através da matrícula de crianças no ensino médio. Este estudo cria um índice de disparidade de riqueza distrital usando a análise de componentes principais e utiliza uma fórmula diferencial para explicar as disparidades socioeconômicas regionais nos distritos de Punjab, no Paquistão.Este documento tiene como objetivo explorar el efecto de la disparidad de riqueza entre los distritos de Punjab en la inscripción escolar de niños de 3 a 14 años de edad para el período 2008, 2011, 2014. Este estudio ha utilizado el modelo probit y también utiliza el componente principal análisis para crear un índice de disparidad de riqueza del distrito para examinar cómo influye en la escolarización de los niños en las economías en desarrollo. Los resultados exponen que la probabilidad de inscripción escolar está influenciada negativamente por la disparidad de riqueza de los distritos en los tres modelos, es decir, para todos los niños. En las variables de control, los hogares que reciben remesas conducen a aumentar la escolarización de los niños. La educación de los padres plantea la posibilidad de escolarizar en los tres modelos. La educación de la madre afecta más la matrícula infantil en comparación con la educación de la cabeza en todos los modelos. Los niños estaban menos dispuestos a estudiar en el año 2007 para los tres modelos. Los resultados sugieren que la disminución de la disparidad entre los distritos de Punjab desea una distribución equivalente de fondos del gobierno de Punjab a los distritos. Puede aumentar el bienestar del hogar mediante la inscripción de niños en la escuela secundaria. Este estudio crea un índice de disparidad de riqueza en el distrito utilizando el análisis de componentes principales y utiliza una fórmula diferencial para explicar las disparidades socioeconómicas regionales en los distritos de Punjab en Pakistán.This paper aims is to explore the effect of wealth disparity between the districts of Punjab on school enrolment of children 3-14 years age group for the period 2008, 2011, 2014. This study has used the probit model and it also uses the principal component analysis to create an index for district wealth disparity to examine how it influences schooling of children in developing economies. The findings expose that probability of school enrolment is negatively influenced by wealth disparity of the districts in all three models, i.e., for all children. In the control variables, the households getting remittances lead to increase the schooling of children. Parents’ education raises the possibility of schooling in all the three models. The education of mother affects child enrolment more as compared education of head in all models. Children were less willing for schooling in the year 2007 for all the three models. The findings suggest that the sliding down the disparity among the districts of Punjab desires equivalent distribution of funds from government of Punjab to the districts. It may increase the household welfare by high school enrolment of children. This study creates district wealth disparity index by using the principal component analysis and uses differential formula to explain the socioeconomic regional disparities across the districts of Punjab in Pakistan

Significance of Persistent Cytogenetic Abnormalities on Myeloablative Allogeneic Stem Cell Transplantation in First Complete Remission

AbstractRisk stratification is important to identify patients with acute myelogenous leukemia (AML) who might benefit from allogeneic hematopoietic stem cell transplantation (allo-HSCT) in first complete remission. We retrospectively studied 150 patients with AML and diagnostic cytogenetic abnormalities who underwent myeloablative allo-HSCT while in first complete remission to evaluate the prognostic impact of persistent cytogenetic abnormalities at allo-HSCT. Three risk groups were identified. Patients with favorable/intermediate cytogenetics at diagnosis (n = 49) and patients with unfavorable cytogenetics at diagnosis but without a persistent abnormal clone at allo-HSCT (n = 83) had a similar 3-year leukemia-free survival of 58%-60% despite the higher 3-year relapse incidence (RI) in the latter group (32.3%, versus 16.8% in the former group). A third group of patients with unfavorable cytogenetics at diagnosis and a persistent abnormal clone at allo-HSCT (n = 15) had the worst prognosis, with a 3-year RI of 57.5% and 3-year leukemia-free survival of only 29.2%. These data suggest that patients with AML and unfavorable cytogenetics at diagnosis and a persistent abnormal clone at allo-HSCT are at high risk for relapse after allo-HSCT. These patients should be considered for clinical trials designed to optimize conditioning regimens and/or to use preemptive strategies in the posttransplantion setting aimed at decreasing RI

Vorinostat Combined with High-Dose Gemcitabine, Busulfan, and Melphalan with Autologous Stem Cell Transplantation in Patients with Refractory Lymphomas

AbstractMore active high-dose regimens are needed for refractory/poor-risk relapsed lymphomas. We previously developed a regimen of infusional gemcitabine/busulfan/melphalan, exploiting the synergistic interaction. Its encouraging activity in refractory lymphomas led us to further enhance its use as a platform for epigenetic modulation. We previously observed increased cytotoxicity in refractory lymphoma cell lines when the histone deacetylase inhibitor vorinostat was added to gemcitabine/busulfan/melphalan, which prompted us to clinically study this four-drug combination. Patients ages 12 to 65 with refractory diffuse large B cell lymphoma (DLCL), Hodgkin (HL), or T lymphoma were eligible. Vorinostat was given at 200 mg/day to 1000 mg/day (days −8 to −3). Gemcitabine was infused continuously at 10 mg/m2/minute over 4.5 hours (days −8 and −3). Busulfan dosing targeted 4000 μM-minute/day (days −8 to −5). Melphalan was infused at 60 mg/m2/day (days −3 and −2). Patients with CD20+ tumors received rituximab (375 mg/m2, days +1 and +8). We enrolled 78 patients: 52 DLCL, 20 HL, and 6 T lymphoma; median age 44 years (range, 15 to 65); median 3 prior chemotherapy lines (range, 2 to 7); and 48% of patients had positron emission tomography–positive tumors at high-dose chemotherapy (29% unresponsive). The vorinostat dose was safely escalated up to 1000 mg/day, with no treatment-related deaths. Toxicities included mucositis and dermatitis. Neutrophils and platelets engrafted promptly. At median follow-up of 25 (range, 16 to 41) months, event-free and overall survival were 61.5% and 73%, respectively (DLCL) and 45% and 80%, respectively (HL). In conclusion, vorinostat/gemcitabine/busulfan/melphalan is safe and highly active in refractory/poor-risk relapsed lymphomas, warranting further evaluation

Outcome of Allogeneic Transplantation for Mature T-cell Lymphomas: Impact of Donor Source and Disease Characteristics

Mature T-cell lymphomas constitute the most common indication for allogeneic hematopoietic cell transplantation (allo-HCT) of all lymphomas. Large studies evaluating contemporary outcomes of allo-HCT in mature T-cell lymphomas relative to commonly used donor sources are not available. Included in this registry study were adult patients who had undergone allo-HCT for anaplastic large cell lymphoma, angioimmunoblastic T-cell lymphoma (AITL), or peripheral T-cell lymphoma not otherwise specified (PTCL-NOS) between 2008 and 2018. Hematopoietic cell transplantation (HCT) platforms compared were posttransplant cyclophosphamidebased haploidentical (haplo-)HCT, matched sibling donor (MSD) HCT, matched unrelated donor HCT with in vivo T-cell depletion (MUD TCD+), and matched unrelated donor HCT without in vivo T-cell depletion (MUD TCD-). Coprimary end points were overall survival (OS) and progression-free survival (PFS); secondary end points included nonrelapse mortality (NRM), and relapse/progression incidence (RI). A total of 1942 patients were eligible (237 haplo-HCT; 911 MSD; 468 MUD TCD+; 326 MUD TCD-). Cohorts were comparable for baseline characteristics with the exception of higher proportions of patients with decreased performance status (PS) and marrow graft recipients in the haplo-HCT group. Using univariate and multivariate comparisons, OS, PFS, RI, and NRM were not significantly different among the haplo-HCT, MSD, MUD TCD+, and MUD TCD- cohorts, with 3-year OS and PFS of 60%, 63%, 59%, and 64%, respectively, and 50%, 50%, 48%, and 52%, respectively. Significant predictors of inferior OS and PFS on multivariate analysis were active disease status at HCT and decreased PS. AITL was associated with significantly reduced relapse risk and better PFS compared with PTCL-NOS. Allo-HCT can provide durable PFS in patients with mature T-cell lymphoma (TCL). Outcomes of haplo-HCT were comparable to those of matched donor allo-HCT

Allogeneic transplantation provides durable remission in a subset of DLBCL patients relapsing after autologous transplantation

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/133605/1/bjh14046.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/133605/2/bjh14046_am.pd

Allogeneic Transplantation Provides Durable Remission in a Subset of DLBCL Patients Relapsing after Autologous Transplantation

For diffuse large B-cell lymphoma (DLBCL) patients progressing after autologous haematopoietic cell transplantation (autoHCT), allogeneic HCT (alloHCT) is often considered, although limited information is available to guide patient selection. Using the Center for International Blood and Marrow Transplant Research (CIBMTR) database, we identified 503 patients who underwent alloHCT after disease progression/relapse following a prior autoHCT. The 3-year probabilities of non-relapse mortality, progression/relapse, progression-free survival (PFS) and overall survival (OS) were 30, 38, 31 and 37% respectively. Factors associated with inferior PFS on multivariate analysis included Karnofsky performance status (KPS) <80, chemoresistance, autoHCT to alloHCT interval <1-year and myeloablative conditioning. Factors associated with worse OS on multivariate analysis included KPS<80, chemoresistance and myeloablative conditioning. Three adverse prognostic factors were used to construct a prognostic model for PFS, including KPS<80 (4 points), autoHCT to alloHCT interval <1-year (2 points) and chemoresistant disease at alloHCT (5 points). This CIBMTR prognostic model classified patients into four groups: low-risk (0 points), intermediate-risk (2-5 points), high-risk (6-9 points) or very high-risk (11 points), predicting 3-year PFS of 40, 32, 11 and 6%, respectively, with 3-year OS probabilities of 43, 39, 19 and 11% respectively. In conclusion, the CIBMTR prognostic model identifies a subgroup of DLBCL patients experiencing long-term survival with alloHCT after a failed prior autoHCT

Allogeneic haematopoietic cell transplantation for extranodal natural killer/Tâ cell lymphoma, nasal type: a CIBMTR analysis

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146342/1/bjh14879.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146342/2/bjh14879_am.pd