2017-2018 Assisted Reproduction Cost Analysis performance indexes: Lombardy County Case Study

Objective The present study investigated the cost per delivery for all public reimbursed ART cycles performed in Lombardy. MethodsAnalysis of costs for the 2017 and 2018 Delivery and Cumulative Delivery Rates extracted from the ART Italian Registry on oocytes retrieval, fresh and frozen embryos and oocytes performed in 22 Lombardy IVF Units. ResultsIn 2017, 29,718 procedures were performed, resulting in 4,543 pregnancies and 3,253 deliveries. In 2018, there were 29,708 procedures, 4,665 pregnancies and 3,348 deliveries. Pregnancies lost to follow up were 5.0% with a (range of 0 to 67.68%) in 2017 and 3.4% (range of 0 to 45.1%) in 2018. The cost reimbursement for the cycles were €2,232 ($2,611) for oocyte retrieval and €2,194 ($2,567) for embryo transfer, excluding ovarian stimulation therapy and luteal phase support.The mean multiple pregnancy delivery rate (MDR) in all 22 IVF centers was 11.08% ± 5,55% (range 0.00% -22.73%) in 2017 and 10.41% ± 4.99 (range 1.33% - 22.22%) in 2018. The mean cost for delivery in euros was 26,227 ± 14,737 in 2017 and 25,018 ± 16,039. The cost difference among centers was 12,480 - 76,725 in 2017 and 12,973 - 86,203 in 2018.Conclusions Our findings suggest the formulation of specific KPI’s (Key performance indexes) and minimal performance indexes (PI) as a basis for the allocation of public or insurance resources. In particular, the reduction of multiple pregnancy rates costs, may lead to a more widespread use of ART even in lower resources countries.

‘VALUE IS NOT A FACT’: REPRODUCTION COST AND THE TRANSITION FROM CLASSICAL TO NEOCLASSICAL REGULATION IN GILDED AGE AMERICA

The paper draws on Stephen Siegel (1984) to argue that, while paving the way for constitutionalizing the free market in Lochner v. New York (1905), the reproduction cost method that the Supreme Court established in Smyth v. Ames (1898) as the preferred technique for assessing the value of a business for regulatory purposes also exposed the conventional character of any valuation exercise, against the claims of objectivity made by classical economists and mainstream jurists. The inconsistency between recognizing that “value is not a fact” and the classical laissez-faire philosophy underlying the Court’s jurisprudence did not escape progressive critics, who concluded that government could legitimately fine-tune regulation in order to affect a business’s value and pursue alternative socio-economic goals.

The Commodification of Knowledge and Information

This entry presents an analysis of the commodification of knowledge and information in contemporary capitalism. We provide a consistent account of how information as a commodity effects the workings of both capitalism and of Marxist theory. The first part of the chapter critically revisits Marx’s own writings on the commodification of knowledge and how the immaterial labor hypothesis initially interpreted these writings. Based on the new categories knowledge-commodity and knowledge-rent, we then present our own approach in response to the challenges raised by the immaterial labor hypothesis. Lastly, there is an analysis of the more recent contributions on the commodification of knowledge and information within the Marxist literature. The current debate on the value of knowledge has been divided between two camps: the reproduction cost approach and the average cost approach. Finally, there is a look at empirical estimates of the magnitudes of knowledge-rents.

Growth potential can affect timing of maturity in a long-lived semelparous fish

Many diadromous fishes such as salmon and eels that move between freshwater and the ocean have evolved semelparous reproductive strategies, but both groups display considerable plasticity in characteristics. Factors such as population density and growth, predation risk or reproduction cost have been found to influence timing of maturation. We investigated the relationship between female size at maturity and individual growth trajectories of the long-lived semelparous European eel, Anguilla anguilla . A Bayesian model was applied to 338 individual growth trajectories of maturing migration-stage female silver eels from France, Ireland, the Netherlands and Hungary. The results clearly showed that when growth rates declined, the onset of maturation was triggered, and the eels left their growth habitats and migrated to the spawning area. Therefore, female eels tended to attain larger body size when the growth conditions were good enough to risk spending extra time in their growth habitats. This flexible maturation strategy is likely related to the ability to use diverse habitats with widely ranging growth and survival potentials in the catadromous life-history across its wide species range.

10 IN VITRO PROGESTERONE RELEASE KINETICS: A COMPARATIVE STUDY OF DIFFERENT INTRAVAGINAL DEVICES USED IN CATTLE

Since progesterone releasing devices have been used for oestrous cycle control, many studies have been done to evaluate the reduce reproduction cost. However, there are few studies about reused devices. The aim of this study was to evaluate and compare in vitro P4 releasing kinetics from 3 commercially available devices: Sincrogest® (SIN, 1 g of P4), Cronipres® (CRO, 1 g of P4 and 3 rings of 0.1 g of P4 for the third use), and Primer® (PRI, 1 g of P4). For each device, new (first use, n = 2), once-used (second use, n = 2), and twice-used (third use, n = 2) devices were tested. The tests were performed in a dissolutor sink using an alcohol/water mixture (60/40, vol/vol) as a release media. Samples were collected at 0–24 h (1P), 24–48 h (2P), 48–72 h (3P), and 72–96 h (4P). Table 1 shows the P4 amount (mg) and standard deviation in the periods in which there was statistical difference (P < 0.05; a–cdifferent letters in the same period differ statistically). The 3 brands of P4 devices differ in 2 of 4, 3 of 4, and 1 of 4 intervals for 1st-, 2nd, and 3rd-use device tests respectively. Additionally, P4 release decreased according to the number of previous uses. It is known that in vitro tests are more sensible to detect differences between devices. Nevertheless, these findings suggest the possibility of targeting different device categories for different animal categories depending on the animal steroid metabolism rate and consequent need for exogenous P4. However, for such a claim, further studies on this topic are needed. Table 1.Comparison between the 3 types in each of 3 uses Supported by FAPESP – Fundação de Amparo a Pesquisa do estado de São Paulo.