43 research outputs found
Monetary Versus Fiscal Policy: Three Essays
The thesis consists of three essays which investigate the relative effectiveness of monetary and fiscal policy.;The first essay analyzes the effect on the real rate of interest of changes in the rate of price inflation and monetary growth which finance either fiscal policy (changes in the tax rate) or financial policy (changes in the bond/money ratio). The second essay investigates the relevance with respect to market and aggregate output of tax versus money financed government expenditure in a natural rate model. The third essay scrutinizes the prediction made by Turnovsky and Brock (1980) that if fiscal authorities do not have access to the rate of monetary expansion any optimal policy will be time inconsistent
Improving statistical models for flood risk assessment
Widespread flooding, such as the events in the winter of 2013/2014 in the UK and early summer 2013 in Cent ral Europe, demonst rate clearly how important it is to understand the characterist ics of floods in which mult iple locat ions experience ext reme river flows. Recent developments in mult ivariate stat ist ical modelling help to place such events in a probabilist ic framework. It is now possible to perform joint probability analysis of events defined in terms of physical variables at hundreds of locat ions simultaneously, over mult iple variables (including river flows, rainfall and sea levels), combined with analysis of temporal dependence to capture the evolut ion of events over a large domain. Crit ical const raints on such data-driven methods are the problems of missing data, especially where records over a network are not all concurrent , the joint analysis of several different physical variables, and the choice of suitable t ime scales when combining informat ion from those variables. This paper presents new developments of a high-dimensional condit ional probability model for ext reme river flow events condit ioned on flow and r ainfall observat ions. These are: a new computat ionally efficient paramet ric approach to account for missing data in the joint analysis of ext remes over a large hydromet ric network; a robust approach for the spat ial interpolation of extreme events throughout a large river network,; generat ion of realist ic est imates of ext remes at ungauged locat ions; and, exploit ing rainfall information rat ionally within the stat ist ical model to help improve efficiency. These methodological advances will be illust rated with data from the UK river network and recent events to show how they cont ribute to a flexible and effective framework for flood risk assessment, with applicat ions in the insurance sector and for nat ional-scale emergency planning
Adjuvant chemotherapy is associated with an overall survival benefit regardless of age in ER+/HER2- breast cancer pts with 1-3 positive nodes and oncotype DX recurrence score 20 to 25: an NCDB analysis
BackgroundThe RxPONDER trial found that among breast cancer patients with estrogen receptor positive (ER+) breast cancer, 1-3 positive axillary nodes, and a recurrence score of ≤25, only pre-menopausal women benefitted from adjuvant chemoendocrine therapy; postmenopausal women with similar characteristic did not benefit from adjuvant chemotherapy. We aimed to replicate the RxPonder trial using a larger patient cohort with real world data to determine whether a RS threshold existed where adjuvant chemotherapy was beneficial regardless of age.MethodsThe National Cancer Database (NCDB) was queried for women with ER+, human epidermal growth factor receptor 2 (HER2) negative breast cancer, 1-3 positive axillary nodes, and RS ≤25 who received endocrine (ET) only or chemo-endocrine therapy (CET). Cox regression interaction was explored between CET and age as a surrogate for menopausal status.ResultsThe final analytic cohort included 28,427 eligible women: 7,487 (26.3%) received adjuvant CET and 20,940 (73.7%) ET. In the entire cohort, RS had a normal distribution, with a median score of 14. After correcting for demographic and clinical variables, a threshold effect was observed with RS >20 being associated with a significantly inferior overall survival (OS) (P value range: < 0.001-0.019). In women with RS of 20-25, CET was associated with a significant improvement in OS compared to ET alone, regardless of age (age <=50: HR = 0.334, P=0.002; age>50: HR=0.521, P=0.019).ConclusionAmong women with ER+/HER2- breast cancer with 1–3 positive nodes, and a RS of 20-25—in contrast to the RxPONDER trial—we observed that CET was associated with an OS benefit in women regardless of age
Model-based inference of conditional extreme value distributions with hydrological applications
Multivariate extreme value models are used to estimate joint risk in a number of applications, with a particular focus on environmental fields ranging from climatology and hydrology to oceanography and seismic hazards. The semi-parametric conditional extreme value model of Heffernan and Tawn involving a multivariate regression provides the most suitable of current statistical models in terms of its flexibility to handle a range of extremal dependence classes. However, the standard inference for the joint distribution of the residuals of this model suffers from the curse of dimensionality because, in a d-dimensional application, it involves a d−1-dimensional nonparametric density estimator, which requires, for accuracy, a number points and commensurate effort that is exponential in d. Furthermore, it does not allow for any partially missing observations to be included, and a previous proposal to address this is extremely computationally intensive, making its use prohibitive if the proportion of missing data is nontrivial. We propose to replace the d−1-dimensional nonparametric density estimator with a model-based copula with univariate marginal densities estimated using kernel methods. This approach provides statistically and computationally efficient estimates whatever the dimension, d, or the degree of missing data. Evidence is presented to show that the benefits of this approach substantially outweigh potential misspecification errors. The methods are illustrated through the analysis of UK river flow data at a network of 46 sites and assessing the rarity of the 2015 floods in North West England
Fiducial marker placement with electromagnetic navigation bronchoscopy: a subgroup analysis of the prospective, multicenter NAVIGATE study
Fiducial markers (FMs) help direct stereotactic body radiation therapy (SBRT) and localization for surgical resection in lung cancer management. We report the safety, accuracy, and practice patterns of FM placement utilizing electromagnetic navigation bronchoscopy (ENB).
Methods:
NAVIGATE is a global, prospective, multicenter, observational cohort study of ENB using the superDimension™ navigation system. This prospectively collected subgroup analysis presents the patient demographics, procedural characteristics, and 1-month outcomes in patients undergoing ENB-guided FM placement. Follow up through 24 months is ongoing.
Results:
Two-hundred fifty-eight patients from 21 centers in the United States were included. General anesthesia was used in 68.2%. Lesion location was confirmed by radial endobronchial ultrasound in 34.5% of procedures. The median ENB procedure time was 31.0 min. Concurrent lung lesion biopsy was conducted in 82.6% (213/258) of patients. A mean of 2.2 ± 1.7 FMs (median 1.0 FMs) were placed per patient and 99.2% were accurately positioned based on subjective operator assessment. Follow-up imaging showed that 94.1% (239/254) of markers remained in place. The procedure-related pneumothorax rate was 5.4% (14/258) overall and 3.1% (8/258) grade ⩾ 2 based on the Common Terminology Criteria for Adverse Events scale. The procedure-related grade ⩾ 4 respiratory failure rate was 1.6% (4/258). There were no bronchopulmonary hemorrhages.
Conclusion:
ENB is an accurate and versatile tool to place FMs for SBRT and localization for surgical resection with low complication rates. The ability to perform a biopsy safely in the same procedure can also increase efficiency. The impact of practice pattern variations on therapeutic effectiveness requires further study
Electromagnetic Navigation Bronchoscopy for Peripheral Pulmonary Lesions: One-Year Results of the Prospective, Multicenter NAVIGATE Study
Exchange Rate "Fundamentals" versus Speculation in a Developing Economy: An Illustrative Example Using Lebanese Data
Competing hypotheses about what causes excessive exchange rate volatility--speculative bubbles or "fundamental" economic variables--are examined for the Lebanese pound during its protracted depreciation from end-1982 to November 1987 and its marked appreciation over the following six months. Reduced-form and time-series models of the exchange rate are estimated and tested for nonstationarity. The results suggest that much of the pound's volatility was consistent with excessive growth in domestic-versus foreign-currency-denominated liquidity rather than speculation.
Recent U.S. Investment Incentives
The apparent slowdown in U.S. investment and productivity growth in recent years has led to a number of proposals to stimulate investment through the adoption of tax incentives. This paper describes the incentives that were contained in the February 1993 Budget and estimates their effect on the user cost of capital. The recent evidence regarding the effect of tax changes on investment in the United States is reviewed, and the likely effect of the Budget’s proposals on investment and overall economic activity is simulated. The simulations suggest that the proposals would have had a stimulative but largely transitory effect on U.S. investment and output.