110 research outputs found

    Reference pricing with elastic demand for pharmaceuticals

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    In this paper, we re‐examine the properties of two commonly adopted government reimbursement schemes for pharmaceuticals: reference pricing and fixed percentage reimbursement. We depart from the previous literature by assuming that the individual demand is price‐sensitive and depends on the copayment rate (i.e., the part paid by each consumer). We obtain two novel results under reference pricing: first, as the copayment rate increases, so do pharmaceutical prices; second, this increase in pharmaceutical prices reduces social welfare. Whilst reference pricing does emerge as a preferable reimbursement scheme, demand elasticities and the copayment rate interact in complex ways. This leads (unexpectedly) to the possibility that a higher copayment rate (lower reimbursement rate) results in higher government expenditure.info:eu-repo/semantics/acceptedVersio

    IMECE2002-32160 SURFACE ROUGHNESS EFFECTS ON CIRCULAR CYLINDERS AT HIGH REYNOLDS NUMBERS

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    ABSTRACT The problem of flow-induced vibration has been studied extensively. However, much of this research has focused on the smooth cylinder to gain an understanding of the mechanisms that cause vortex-induced vibration. In this paper results of an investigation of the effect of surface roughness on the crosswind forces are presented. Measurements of the sectional RMS fluctuating lift forces and the axial correlation of the pressures for Reynolds numbers from 1 x 10 5 to 1.4 x 10 6 are given. It was found that surface roughness significantly increased the axial correlation of the pressures to similar values found at high subcritical Reynolds numbers. There was little effect of the surface roughness on the sectional lift forces. The improved correlation of the vortex shedding means rough cylinders will be subject to larger cross-wind forces and an increased possibility of vortex-induced vibration compared to smooth cylinders. INTRODUCTION The problem of vortex-induced vibration confronts us in many everyday situations; from the vibration of a domestic television aerial to flow over heat exchanger tube banks to large towers, and in some situations left untreated can lead to structure failures. The importance of finding causes and solutions to vortex induced vibration is reflected in the quantity of research. Many of the circular cylinder applications mentioned in the previous paragraph are not highly polished, instead they have a degree of surface roughness caused by manufacturing tolerances or environmental conditions. Research on smooth cylinders in low turbulence flow has shown the fluid-structure mechanisms that result in vibration over a wide range of Reynolds numbers. However, the quantity of research data available showing the effect of surface roughness an

    Tiny Publics and Social Worlds—Toward a Sociology of the Local. Gary Alan Fine in Conversation With Reiner Keller

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    Gary Alan FINE gehört weltweit zu den prominentesten Persönlichkeiten der zeitgenössischen soziologischen Ethnografie. In diesem GesprĂ€ch spricht er ĂŒber EinflĂŒsse in seiner akademischen Laufbahn und prĂ€gende intellektuelle Entscheidungen. Er gilt als "serieller Ethnograf", der in zahlreichen Feldkontexten gearbeitet hat und dabei einerseits Kleingruppen und eine von Menschen bevölkerte Ethnografie favorisiert, sich andererseits mit GerĂŒchten, Klatsch und moralischen Geschichten beschĂ€ftigt, die in kleinen und grĂ¶ĂŸeren Publiken erzĂ€hlt werden. FINE beschreibt sein theoretisches Kerninteresse als die Untersuchung des Wechselspiels von Struktur, Interaktion und Kultur. In seinem Werk analysiert er die vielfĂ€ltigen ortsgebundenen Arten und Weisen, in denen Gesellschaft von Menschen in formellen und informellen sozialen Settings verwirklicht wird, angefangen bei Baseballteams ĂŒber RestaurantkĂŒchen oder die Wetterberichterstattung bis hin zum Schachspielen –um nur einige wenige GegenstĂ€nde seiner Forschungen zu nennen. Wesentlich beeinflusst durch symbolisch-interaktionistisches Denken und im Rekurs auf weitere wichtige Perspektiven auf soziale Welten plĂ€diert er fĂŒr eine selbstbewusste Haltung der ethnografischen Forschung und des ethnografischen Schreibens sowie fĂŒr die Bedeutung der Konzeptarbeit in einer theorie-informierten empirischen Soziologie dessen, was Menschen zusammen tun.Gary Alan FINE is among the most prominent figures in contemporary sociological ethnography worldwide. In this conversation, he talks about influences in his academic career and key intellectual choices. Considered to be a "serial ethnographer" who has worked in multiple settings, his work focuses on small groups and peopled ethnography, as well as on rumors, gossip, and moral story telling in tiny and larger publics. FINE describes his core theoretical interest as residing in the interplay of structure, interaction, and culture and discusses the multiple local ways society is realized by people in formal and informal social settings: ranging from baseball teams, restaurant kitchens, weather reporting to chess players—to name but a few research sites. Influenced by symbolic interactionist thinking and other important approaches to social worlds, he argues for a confident voice of ethnographic research and writing as well as the importance of conceptual work in a theory-informed empirical sociology of what people do together

    The Effects of Heparins on the Liver: Application of Mechanistic Serum Biomarkers in a Randomized Study in Healthy Volunteers

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    Heparins have been reported to cause elevations in serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) but have not been associated with clinically significant liver injury. The mechanisms underlying these benign laboratory abnormalities are unknown. Forty-eight healthy men were randomized to receive subcutaneous injections of unfractionated heparin (UFH; 150 U/kg), enoxaparin sodium (1 mg/kg), dalteparin sodium (120 IU/kg), or adomiparin sodium (125 IU/kg; a novel heparin) every 12 h for 4.5 days. Asymptomatic elevations in serum ALT or AST were observed in >90% of the subjects. Elevations were also observed in the levels of serum sorbitol dehydrogenase (SDH), glutamate dehydrogenase (GLDH), miR-122, high-mobility group box-1 protein (including the acetylated form), full-length keratin 18, and DNA. Keratin 18 fragments, which are apoptosis biomarkers, were not detected. Biomarker profiles did not differ significantly across heparin treatments. We conclude that heparins as a class cause self-limited and mild hepatocyte necrosis with secondary activation of an innate immune response
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