Sunday, May 20, 2018

A quick look back at the politics of electricity markets

This, from the RTO Insider, which bills itself as "Your Eyes and Ears on the Organized Electric Markets."

Former FERC Chairs Reminisce, Sound Off at EBA

"The Energy Bar Association closed its annual meeting last week with a panel discussion with five former FERC chairs whose terms collectively spanned two decades. The former chairs offered entertaining anecdotes about the past while expressing pride over the growth of competitive markets — and frustration over forces they said threaten them."

Saturday, May 19, 2018

Afshin Nikzad defends (x2)

Defense 2, (Offense 0).
Afshin Nikzad defended twice in eight days, to qualify for two Ph.D.s, one from Management Science and Engineering, in Operations Research, and one from Economics (in economics:).  Here are photos from his Economics defense.

Afshin Nikzad and some of his admirers: Philip Strack, Fuhito Kojima, Daniela Saban, Niloufar Salehi, Al Roth, Afshin, Paul Milgrom, and Itai Ashlagi

The papers he presented for his Economics defense were
Thickness and Competition in Ride-sharing Markets 
Financing Transplant Costs of the Poor: A Dynamic Model of Global Kidney Exchange 

The papers he presented for his MS&E defense were 
Approximate Random Allocation Mechanisms 
What matters in tie-breaking rules? How competition guides design 

Welcome to the club(s), Afshin

Friday, May 18, 2018

Eric Budish on (expensive) blockchain technology

The Economic Limits of the Blockchain
by Eric Budish
May 3, 2018

Abstract: The amount of computational power devoted to blockchains such as Bitcoin’s must simultaneously satisfy two conditions in equilibrium: (1) a zero-profit condition among miners,who engage in a rent-seeking competition for the prize associated with adding the next block to the chain; and (2) an incentive compatibility condition on the system’s vulnerability to a“majority attack”, namely that the computational costs of such an attack must exceed the benefits. Together, these two equations imply that (3) the recurring, “flow”, payments to miners for running the blockchain must be large relative to the one-off, “stock”, benefits of attacking it. The constraint is softer (i.e., stock versus stock) if both (i) the mining technology used to run the blockchain is both scarce and non-repurposable, and (ii) any majority attack is a “sabotage” in that it causes a collapse in the economic value of the blockchain; however, reliance on non-repurposable technology for security and vulnerability to sabotage each raise their own concerns, and point to specific collapse scenarios. Overall the results place potentially serious economic constraints on the applicability of the Nakamoto (2008) blockchain innovation. The anonymous, decentralized trust enabled by the blockchain, while ingenious, is expensive.

Thursday, May 17, 2018

Liver exchange in the U.S.?

 From  Liver Transplantation 24 677–686 2018 

Liver paired exchange: Can the liver emulate the kidney?
Ashish Mishra  Alexis Lo  Grace S. Lee  Benjamin Samstein  Peter S. Yoo Matthew H. Levine  David S. Goldberg  Abraham Shaked  Kim M. Olthoff Peter L. Abt

Abstract: Kidney paired exchange (KPE) constitutes 12% of all living donor kidney transplantations (LDKTs) in the United States. The success of KPE programs has prompted many in the liver transplant community to consider the possibility of liver paired exchange (LPE). Though the idea seems promising, the application has been limited to a handful of centers in Asia. In this article, we consider the indications, logistical issues, and ethics for establishing a LPE program in the United States with reference to the principles and advances developed from experience with KPE. 

"The potential number of donor and recipient pairs that might be suitable for LPE in the United States is unknown and is dependent on numerous factors. However, the Asan Medical Center experience from South Korea provides some perspective; among 2182 LDLT patients, 26 involved LPE.3 In the United States, most donors selected for LPE will likely be those where the donor is appropriate to donate with regard to the usual anatomical, medical, and psychosocial dimensions, but for 1 reason or another not appropriate for his or her intended recipient. Centers that evaluate living liver donors follow a stepwise approach to determining eligibility for donation. Some donors are rejected early in the evaluation process for obesity or other comorbidities, age, or being psychosocially unfit to proceed with donation.16, 17 Those who pass the initial screening process are assessed further for blood type, liver volumes, and other anatomical considerations, as well as general medical and psychosocial concerns. The donors who are rejected at this stage in the evaluation are the ones who could be considered for LPE. It is estimated that 3.5%‐17.0% of donors are rejected for ABOi, 4.1%‐14.0% for inadequate hepatic mass to support the recipient, and 1.5%‐6.0% due to vascular or biliary anatomic variations.17-20 There is considerable variation of these estimates based on the order of tests and the screening processes used to evaluate potential donors based on transplant center‐specific donor criteria. These barriers to donation represent opportunities for a variety of exchanges between donor and recipient pairs, such that the total number of lives saved through LDLT could be increased."

Examples of Potential LPE

In the following section, we provide some examples of potential LPE. If the history of KPE serves as a guide for the trajectory of LPE, the number of pairs involved, the indications for participation, and the complexity of exchanges are likely to increase (Fig. 2).
  1. Two‐way swap: ABOi pair and a pair where the estimated weight of the donor lobe is inadequate for the intended recipient (Fig. 2A).
  2. Three‐way swap: ABO compatible pair where the remnant volume is too small for the donor; ABOi donor to small child where the left lateral segment (LLS) is also too large for the child; and an ABOi pair (Fig. 2B).
  3. Nondirected donor starts a chain (Fig. 2C).
  4. Patient with familial amyloid polyneuropathy (FAP) receives a deceased donor organ or LDLT and starts a chain with a domino liver (Fig. 2D).

Wednesday, May 16, 2018

"Economics that works" in Bloomberg, celebrates Parag Pathak as a reply to some critics of economics

A Top Econ Prize for a Theory That Works
This economist figured out a better way to assign students to public schools.
By Noah Smith, May 15

Here are the opening lines:

"What do people think economic theorists do? The pundits who regularly criticize the profession, particularly in the pages of British magazines, seem to think that they spend all their time making abstruse, unrealistic theories about how free markets are the best of all possible worlds. And it's true that there are still a few economists out there who are essentially doing that. But a lot of theorists are doing something much more humble and practical work on small-bore theories that can be immediately applied to make the real world a little more efficient.

Parag Pathak is a theorist of this latter type. "

And here are the closing lines (what's in between is well worth reading too:)

"In an age when bashing economics is in vogue, the critics should pay attention to researchers like Pathak. Their theories are not as grandiose as the macroeconomic ideas that appear in the press — but they really work, and every day they improve people’s lives."

Tuesday, May 15, 2018

Dick Thaler reflects on nuts to nudges--The economist as story teller

Some Thaler stories, from the horse's mouth

Behavioral economics from nuts to ‘nudges’
A bowl of cashews led to a research breakthrough
by Richard H. Thaler

"People think in stories, or at least I do. My research in the field now known as behavioral economics started from real-life stories I observed while I was a graduate student at the University of Rochester. Economists often sneer at anecdotal data, and I had less than that—a collection of anecdotes without a hint of data. Yet each story captured something about human behavior that seemed inconsistent with the economic theory I was struggling to master in graduate school. Here are a few examples:..."

Monday, May 14, 2018

Kidney Exchange in India: current conditions and recommendations for the future

The Indian Society of Organ Transplantation has published guidelines for expanding kidney exchange in India:

Kute VB, Agarwal SK, Sahay M, Kumar A, Rathi M, Prasad N, Sharma RK, Gupta KL, Shroff S, Saxena SK, Shah PR, Modi PR, Billa V, Tripathi LK, Raju S, Bhadauria DS, Jeloka TK, Agarwal D, Krishna A, Perumalla R, Jain M, Guleria S, Rees MA. Kidney-paired donation to increase living donor kidney transplantation in India: Guidelines of Indian Society of Organ Transplantation – 2017. Indian J Nephrol 2018;28:1-9

Here's the summary of their recommendations:

"Evidence-based recommendations, suggestions, and expert consensus statements in this document aim to expand KPD and may serve as a model for other developing countries. For these guidelines, all reference articles in the English literature related to KPD transplantation in India from MEDLINE (PubMed from 2000 to 2017) database were included and reviewed.

We recommend that each potential DRP should be educated, encouraged, and counseled about KPD transplant in an easy-to-understand format as early as possible in the process of chronic kidney disease (CKD) care.

We recommend that all the transplant team members including transplant coordinator in addition to other regular training should also be trained for counseling about risk, benefits of KPD, nonexchange options, consent process, financial screening of DRP, data entry-related issues of KPD, and overall support for KPD.

We recommend that a standard written informed consent should be obtained from each DRP. We suggest that DRP should be given information about expected waiting time before transplantation, and every attempt should be made to reduce waiting time, particularly for hard-to-match pairs with the innovative ways in KPD matching.

We suggest that easy-to-match pairs (A donor and B recipient and vice versa) and sensitized pairs should be encouraged for KPD over ABO-incompatible kidney transplantation (ABOiKT) and desensitization protocol.

We recommend that all types of KPD should be practiced only after legal permission as per the existing transplant law.

We suggest that three-way exchange has optimum quality and quantity of matching.

We suggest that potential KPD transplant centers should study the key elements of success of other successful KPD program.

We suggest that computerized algorithms should be encouraged over manual allocation.

We recommend that all patients should be screened for pretransplant immunological risk, occult infections, and other risk factors to prevent and reduce posttransplant unequal outcome due to patient-related factors.

We suggest that the age difference between KPD donors should not be the key issue in allocation and better immunological match may counteract the effect of higher donor–recipient age difference.

We recommend that participating transplant teams should make the decision by consensus about kidney donor travel versus kidney transport as per local resources and logistics, though donor travel rather than kidney transport is likely to be simple.

We suggest that transplant surgery should be performed at the place where patient is evaluated, admitted, and willing to do posttransplant follow-up and simultaneous rather than sequential surgery should be preferred.

We recommend that the formation of KPD registry is one of the principal strategies to improve the quality of matching and number of KPD.

We suggest that DRP needs to be cognizant of transcultural, language, and legal barriers in national program when patients and their donors may belong to different regions or states of India."

And here's the introductory summary of the background in India:

The Indian CKD registry in 2010 reported that at the time of enrolment in registry, 61% of end-stage renal disease (ESRD) patients were not on any form of renal replacement therapy (RRT), while 32% were on hemodialysis, 5% on peritoneal dialysis, and only 2% were being worked up for kidney transplantation.[1] There is a gross disparity between supply and demand of the transplant organs across the world, including India. All efforts are to be made to increase the supply of quality organs to the waiting transplant recipients. KPD is one such process for increasing supply of organs to patients waiting for transplant. ABO-compatible living donor kidney transplant (LDKT) is the ideal and cost-effective RRT modality for ESRD patients in resource-limited developing country such as India, where morbidity and mortality on long-term dialysis is unacceptably high. Access to RRT is mainly prevented by paucity of facilities and affordability. Up to 80% of kidney donors are living donors, while DDKT programs are still evolving in most parts of India.

KPD transplant enables two incompatible DRP to receive more compatible kidneys. In this, a living kidney donor who is otherwise incompatible with the recipient exchanges kidneys with another DRP. KPD can be performed at any transplant center that is doing kidney transplantation without the need of extra facilities as required for ABOiKT and transplant with desensitization protocol.