A note on forward contracts in leader-follower games

This note shows that the pro-competitive effect of pre-commitments is robust to Stackelberg-like market structures. Although our results are in line with Allaz and Vila (1993), the two equilibria differ substantially. Sequential interactions foster a monopolization of the contract market and a redistribution of market shares - and hence of profits - towards the follower. Offsetting strategies in the sense of Bain (1949a) can then occur. The use of forward sales to exclude the rival in the output market requires the leader to have a strategic advantage in the contract market, as well as some conditions on the technological structure of the industry.

Long-term survival in elderly patients with a do-not-intubate order treated with noninvasive mechanical ventilation

Paolo Scarpazza1, Cristoforo Incorvaia2, Paolo Amboni3, Giuseppe di Franco1, Stefania Raschi1, Pierfranco Usai1, Monica Bernareggi1, Cristiano Bonacina1, Chiara Melacini1, Roberta Cattaneo1, Serena Bencini1, Chiara Pravettoni2, Gian Galeazzo Riario-Sforza2, Gianni Passalacqua4, Walter Casali11Divisione di Broncopneumotisiologia, Ospedale Civile, Vimercate, Italy; 2Pulmonary Rehabilitation, Istituti Clinici di Perfezionamento, Milan, Italy; 3Clinical Chemistry Laboratory, Ospedali Riuniti, Bergamo, Italy; 4Allergy and Respiratory Diseases, University Of Genoa, Genoa, ItalyBackground: Noninvasive mechanical ventilation (NIMV) is an effective tool in treating patients with acute respiratory failure (ARF), since it reduces both the need for endotracheal intubation and the mortality in comparison with nonventilated patients. A particular issue is represented by the outcome of NIMV in patients referred to the emergency department for ARF and with a do-not-intubate (DNI) status because of advanced age or excessively critical conditions. This study evaluated long-term survival in a group of elderly patients with acute hypercapnic ARF who had a DNI order and who were successfully treated by NIMV.Methods: The population consisted of 54 patients with a favorable outcome after NIMV for ARF. They were followed up for 3 years by regular control visits, with at least one visit every 4 months, or as needed according to the patient’s condition. Of these, 31 continued NIMV at home and 23 were on long-term oxygen therapy (LTOT) alone.Results: A total of 16 of the 52 patients had not survived at the 1-year follow-up, and another eight patients died during the 3-year observation, with an overall mortality rate of 30.8% after 1 year and 46.2% after 3 years. Comparing patients who continued NIMV at home with those who were on LTOT alone, 9 of the 29 patients on home NIMV died (6 after 1 year and 3 after 3 years) and 15 of the 23 patients on LTOT alone died (10 after 1 year and 5 after 3 years).Conclusion: These results show that elderly patients with ARF successfully treated by NIMV following a DNI order have a satisfactory long-term survival.Keywords: COPD, acute respiratory failure, mortality rate, respiratory failur

Clinical effectiveness of routine first-trimester combined screening for pre-eclampsia in Spain with the addition of placental growth factor

Pre-eclampsia affects 2%-8% of pregnancies and is one of the leading causes of maternal and perinatal morbidity and mortality. First-trimester screening using an algorithm that combines maternal characteristics, mean arterial blood pressure, uterine artery pulsatility index and biomarkers (pregnancy-associated plasma protein-A and placental growth factor) is the method that achieves a greater diagnostic accuracy. It has been shown that daily salicylic acid administration before 16 weeks in women at a high risk for pre-eclampsia can reduce the incidence of preterm pre-eclampsia. However, no previous studies have evaluated the impact of routine first-trimester combined screening for pre-eclampsia with placental growth factor after being implemented in the clinical practice. This was a multicenter cohort study conducted in eight different maternities across Spain. Participants in the reference group were prospectively recruited between October 2015 and September 2017. Participants in the study group were retrospectively recruited between March 2019 and May 2021. Pre-eclampsia risk was calculated between 11 +0 and 13 +6 weeks using the Gaussian algorithm combining maternal characteristics, mean arterial pressure, uterine arteries pulsatility index, pregnancy-associated plasma protein-A and placental growth factor. Patients with a risk greater than 1/170 were prescribed daily salicylic acid 150 mg until 36 weeks. Patients in the reference group did not receive salicylic acid during gestation. A significant reduction was observed in preterm pre-eclampsia (OR 0.47; 95% CI: 0.30-0.73), early-onset (<34 weeks) pre-eclampsia (OR 0.35; 95% CI: 0.16-0.77), preterm small for gestational age newborn (OR 0.57; 95% CI: 0.40-0.82), spontaneous preterm birth (OR 0.72; 95% CI: 0.57-0.90), and admission to intensive care unit (OR 0.55; 95% CI: 0.37-0.81). A greater treatment adherence resulted in a significant reduction in adverse outcomes. Routine first-trimester screening for pre-eclampsia with placental growth factor leads to a reduction in preterm pre-eclampsia and other pregnancy complications. Aspirin treatment compliance has a great impact on the effectiveness of this screening program. Routine first-trimester combined screening for pre-eclampsia in Spain with the addition of placental growth factor resulted in a significant reduction of pre-eclampsia and other pregnancy complications

The automotive industry: when regulated supply fails to meet demand. The Case of Italy

This paper studies the effects of the latest European regulations on carbon emissions on the Italian car market and discusses the possibility of achieving climate neutrality of road transport through the “mere” replacement of cars currently on the road with new zero-emission cars. Since 2016, automakers’ production strategies have changed dramatically, with an increasing number of zero (and low) emission models on car lists. To date, these changes on the supply side have not been matched by similar changes in purchasing habits. In recent years, not only have few zero (and low) emission cars been sold, but also few new cars. Unless epoch-making changes occur, it is completely unrealistic to think that we can achieve climate neutrality by 2050 by leveraging exclusively on the renewal of the fleet

A note on forward contracts in leader-follower games'

This note shows that the pro-competitive effect of pre-commitments is robust to Stackelberg-like market structures. Although our results are in line with Allaz & Vila (1993)'s, the two equilibria di¤er substantially. Sequential interactions foster a monopolization of the contract market and a redistribution of market shares - and hence of profits - towards the follower. Offsetting strategies in the sense of Bain (1949a) can then occur. The use of forward sales to exclude the rival in the output market requires the leader to have a strategic advantage in the contract market, as well as some conditions on the technological structure of the industry

Gas storage services and regulation in Italy:A Delphi analysis

The objective of this paper is to assess to which extent gas market inefficiencies, such as weak competition, import dependence and lack of flexibility tools, affect operation and usage of storage services in Italy in the aftermath of the EU liberalization process

Final Remarks and Policy Recommendations

We discuss the main results of the models presented in the book and draw some policy lesson

Gas storage services and regulation in Italy: A Delphi analysis

The objective of this paper is to assess to which extent gas market inefficiencies, such as weak competition, import dependence and lack of flexibility tools, affect operation and usage of storage services in Italy in the aftermath of the EU liberalization process. The analysis is supported by the empirical results of a Delphi survey that we have conducted to investigate storage service provision and regulation in Italy. We argue that the Italian storage sector is at a crossroads. The policy-driven phase of liberalization is ending and the market-driven phase has just begun. The former phase has granted fair access to storage, narrowed the likelihood of strategic behaviour by the incumbent and secured residential users against supply disruptions, but it has proved dynamically inefficient. Cost-reflective tariffs and low penalties for unbalances have both lowered incentives to expand the range of flexibility tools and penalized industrial customers demand. The market-driven phase has just started. The expected increase in working capacity and the entry of newcomers in the authorization process for new facilities are a progress towards the commercial use of storage. To this end, however, a further change in gas market design is needed: the creation of a well functioning spot market.Italian gas market Storage Delphi survey