La fiscalité incitative en R&D: Conséquences sur les investissements privés en recherche et développement dans les provinces canadiennes

Rapport de recherche présenté à la Faculté des arts et des sciences en vue de l'obtention du grade de Maîtrise en sciences économiques

Subways and Urban Air Pollution.

We investigate the effect of subway system openings on urban air pollution. On average, particulate concentrations are unchanged by subway openings. For cities with higher initial pollution levels, subway openings reduce particulates by 4 percent in the area surrounding a city center. The effect decays with distance to city center and persists over the longest time horizon that we can measure with our data, about four years. For highly polluted cities, we estimate that a new subway system provides an external mortality benefit of about $1 billion per year. For less polluted cities, the effect is indistinguishable from zero. Back of the envelope cost estimates suggest that reduced mortality due to lower air pollution offsets a substantial share of the construction costs of subways

Multifocal Humeral Fractures: Clinical Results, Functional Outcomes and Flowchart of Surgical Treatment

Aim and objective: Multifocal fractures of the humerus are rare. The aim of our study is to evaluate the effectiveness of surgical treatment and propose a modification to the Maresca-Pascarella classification. A flowchart for surgical treatment is provided.Materials and methods:Thirty-one patients with multifocal humeral fractures were treated and evaluated.The Maresca-Pascarella classification was used. All were treated using with either plates and screws, external fixation or intramedullary nailing. Functional outcomes were evaluated using the QuickDASH test, the University of California - Los Angeles (UCLA) shoulder score and the Mayo elbow performance score (MEPS).Results: There were 12 Type A, 17 Type B, 1 Type C and 1 of combined fractures of the proximal and distal epiphysis. Of the 31 patients, 5 were lost to the follow-up (FU), 1 died of pulmonary embolism (PE) and the remaining 25 had a mean FU of 19.8 (7-35) months. Three patients had radial nerve damage and 1 went to a non-union that required further surgical intervention. The mean QuickDASH score was 15.7, the average UCLA shoulder score was 26.3 and the mean MEPS elbow score resulted to be 83.0.Conclusion: Although multifocal fractures are severe injuries, patients are able to recover good functionality if treated judiciously

Outcome and toxicity in the modern era of new drugs for multiple myeloma: A reappraisal for comparison with future investigational trials

The introduction of new drugs such as thalidomide, lenalidomide, and bortezomib has led to novel treatment strategies and significantly improved the outcome of patients with multiple myeloma (MM). The enhanced knowledge of myeloma pathogenesis has allowed the identification of new therapeutic targets and many clinical trials are either planned or in progress to evaluate these more selective drugs in the near future. The results of these studies, however, will have to be compared with the results of existing novel therapies for the treatment of MM in order to define whether new protocols do not duplicate current new standards and constitute a real improvement. We reviewed the results of a series of phase I, II, III studies with thalidomide, lenalidomide, and bortezomib combinations for newly diagnosed MM in order to define a reasonable standard in terms of activity, efficacy, and toxicity and to have a potentially useful starting point for comparisons with future investigational trials. Three-drug regimens appear to double the complete remission (CR) rate (20%), though regimens containing 4 drugs triple the CR rate (30%), compared with those containing only 2 agents (10%). These improvements in the depth and quality of response translate into a progressive increase in the progression-free survival rate at 2 years (from approximately 54%-62% to 75%, respectively). Conversely, by using additional agents, a marked increase in hematologic toxicity has been described (8%, 28%, and 28% respectively), whereas nonhematologic toxicity appears to be similar (26%, 24%, and 27%, respectively). These results suggest that new trials in the future will constitute significant progress if they can improve on the current relatively favorable efficacy/toxicity ratio. Nonetheless, exciting new combinations in development do hold promise and results from these studies are eagerly awaited