The main purpose of this study is to investigate how structural separation policies (especially vertical separation and the holding company) affect the costs of the rail industry, and to explore the mechanisms through which these cost impacts occur. We contribute to the past literature by focusing on investment coordination/misalignment costs and how these might vary across different railway structures. We also provide a substantially more up-to-date view of the impact of rail reforms than in previous cost function studies. A total cost function is used with a dataset involving 33 European and East Asia railway companies (1994-2017). We find that there is no “one size fits all” vertical structure from the point of view of cost minimisation and that the optimal structure from a cost perspective depends on both train density and the intensity of infrastructure investment.

The trend of the last 40 years in the transport sector has been towards deregulation, and in the US that has also been true of the rail sector, where in 1980 the Staggers Act largely removed regulation. Essentially it has been a part of the reform of European railways designed to achieve at least a degree of separation of infrastructure from operations and to introduce competition between different freight and passenger operators over the same infrastructure. This chapter focuses on the reasons for rail regulation in the European context. It then turns to the literature for guidance on the nature of the regulatory body most likely to succeed in regulating the rail sector. The chapter concludes that Britain comes close to having such a rail regulator and examines the experience of Britain and the degree to which its rail regulatory body has succeeded in its objectives.

Stated preference surveys are typically used to derive lateness multipliers, defined as a trade-off between a minute of lateness and scheduled journey time. This study aims to use a novel in the context of lateness valuation dataset (i.e. responses from a survey on journey satisfaction) to apply it to the established methodologies. Travel satisfaction data from National Rail Passenger Survey in Great Britain is used to estimate the impacts of scheduled journey time and delay on passenger satisfaction. An ordered logit model with origin–destination pair fixed effects is estimated and lateness multipliers are subsequently derived. The estimated values are slightly larger than previously suggested, ranging from 4 to 9 for arrival delay (i.e. a minute of arrival delay is valued as an equivalent of 4–9 min of scheduled journey time) and 2 to 6 for departure delay. This study offers a degree of novelty in terms of the type of data used in the estimation process and highlights the potential of satisfaction surveys in economic valuation in transport.

Background A rail passenger delay compensation scheme aiming at improving attractiveness of rail services and providing minimum customer service standards for delayed passengers operates in the European Union and Great Britain. British rail passengers are eligible to claim 50% of fare for delays of more than 30 min and 100% for delays of over 1 h. The scheme rules were chosen arbitrarily and are homogeneous across all ticket types and journey lengths. As longer journeys are usually more expensive and subjected to longer delays, long distance operators are likely to see more passengers being eligible to claim compensation. This, combined with higher engagement rates due to differences in sensitivity to lateness or opportunity cost of not claiming compensation is likely to have an impact on the differing revenue burden for operating companies. Objective Against this background, this study aims to quantify the revenue impact of homogeneity of scheme rules for different types of train operators to advance understanding of the scheme’s costs and motivate further research into the economic rationale behind the scheme’s provision and design. Methodology An econometric model was constructed to empirically test the impact of performance levels and train operator characteristics on the compensation payments made to passengers through the ’Delay Repay’ scheme in Great Britain. Results The combined differences in the nature of operation and engagement levels mean that with delay levels and engagement increasing with journey length and fare, short, medium and long distance train operating companies (TOCs) repay on average respectively 0.3%, 0.8% and 1.8% of their ticket revenues, increasing the scheme’s proportionate burden on the revenues of long distance operators. Further research is needed to either explain the economic or regulatory reasons behind the differing revenue impact of the scheme on different types of TOCs or suggest how the scheme can be redesigned to take these differences into account.

The problem of slow productivity growth in the road construction (and wider construction) industry is well known. The present paper suggests a means for efficiency analysis in one part of this industry, namely road surface renewal in Sweden, built upon the application of Stochastic Frontier Analysis (SFA) techniques. The paper is novel in that it focuses on project level rather than firm or contractor level performance and takes the perspective of the inefficiency that may result from the way the contracts are specified by the highway agency’s pavement engineers (client side). We compare 233 renewal contracts tendered over a four-year period via the estimation of a cost frontier, with controls for heterogeneity between projects. Our results produce first estimates that expose substantive differences in the relative efficiency performance of different engineers within the Swedish highways procurement organisation (Trafikverket); with indicative savings of around €40 m out of a total road renewals budget in Sweden of €200 m. We also find substantial economies of scale that could, in principle, point to further cost savings if road renewal projects can be packaged up as larger projects. These client-side savings represent potentially important sources of savings in addition to those that can be achieved through the pressure of competitive tendering on the supplier side. The paper therefore illustrates how disaggregate analysis of project level information can readily be used for revealing important information about how best to frame the procurement process and thus deliver productivity and unit cost improvements over time.

This paper re-examines the implementation of the short run marginal cost (SRMC) pricing principle with respect to rail infrastructure usage and empirically tests if there are rail infrastructure maintenance costs triggered by traffic but not caused by asset damage from traffic. This is important because current EU legislation stipulates that only costs related to infrastructure wear and tear from traffic are eligible for the direct cost-based element of track access charges. An econometric approach is applied to French panel data on signalling maintenance costs. The results show that the SRMC for infrastructure provision of these assets is not only related to asset damage costs caused by traffic, but can also be due to economic factors linked to increased line capacity utilisation: 1) higher cost per maintenance activity, and/or 2) increased preventative maintenance to curb delays. Our work offers an explanation as to why econometric and engineering approaches give different views of rail infrastructure cost variability and suggests that EU legislation on track access pricing may need to be revised.

In the 1990s Great Britain embarked on one of the most radical railway reforms undertaken anywhere in the world, with full vertical separation and privatisation of all aspects of the railway and the introduction of competition throughout the sector. However, since then Britain's railways have been plagued with multiple problems, most notably a failure to control costs, as well as multiple franchise failures and problems with developing sensible timetables, with consequent impacts on train performance. Multiple attempts to reform the initial model have failed and in 2018/2019 a fundamental review was undertaken which culminated in the publication of the Williams-Shapps plan for rail which proposes a major step back towards vertical integration with the establishment of a new government owned organisation to take charge both of infrastructure and services, although the latter will be operated by private companies under concessions. This paper reviews the reasons behind the problems experienced by Britain's railways - which led to the review - before setting out the proposed reforms and discussing whether they might solve the problems and what some of the critical success factors might be.

This paper uti lises a unique data set to study the scale and den sity prop er ties of rail infra struc ture main te-nance, distinguishing between dif fer ent tech nol o gies existing within national rail systems; namely, urban, high-speed, and regional lines. We find dif fer ences in the posi tion and shapes of the alter na tive tech nol o gies, with returns to scale and den sity prop er ties vary ing by net work type. Such tech nol ogy-disaggregated cost struc ture char ac ter is tics have not pre vi ously been derived in the literature, and have impli ca tions for track access charges and rail way main te nance orga ni sa tion. Additionally, the widely used translog func tional form is shown to be insuf fi ciently flex i ble to deal with the dif fer ent tech nol o gies under con sid er ation.

In this chapter, the experience of production and cost analysis in transportation is reviewed. The key production and cost analysis needs of the sector can be identified providing strategic operational insight, establishing evidence as to which market and regulatory structures yield best outcomes and providing the evidence base for regulatory scrutiny either through yardstick competition or more formal price cap regulation. The upshot of this is that transportation has provided the motivation and illustration for many innovations within production, cost, and efficiency methods, and this chapter brings to life the issues and solutions found in the sector.

Efficay and safety of SARS-CoV-2 vaccine in this population is still yet to be established.It has been described, immune thrombotic thrombocytopenia, myocarditis and Guillain-Barre syndrome in individuals who received the ChAdOx1 SARS-CoV-2 vaccine.There are very few cases of acute rejection after SARS-CoV-2 vaccination post HT patients.We will describe a several outcome of heart function vaccine-induced.Case Report: A 46-year-old heart transplanted male since 2015, started with persistent cough 15 days after a dose of adenoviral vector-based vaccine against SARS-CoV-2.As he had increased troponin and new left ventricular dysfunction, he underwent an endomyocardial biopsy, collected an panel reactive antibodies (PRA) and started pulse dose metylprednisolone.He developed an ischemic electrocardiographic alteration with a ST elevation and the coronary angiography found a thrombosis in the anterior descending coronary artery with no success with percutaneous treatment.Endomyocardial biopsy found no acute rejection, and PRA showed de novo donor specific antibodies (DSA).Despite treatment for antibodiemediated rejection with plasmapheresis, human immunoglobulin and rituximab, he had a cardiogenic shock, refractory to inotropic support and intra-aortic balloon pump, requiring peripheral VA ECMO.Regardless of initial hemodynamic response and partial recovery of biventricular function, patient could not stand weaning from ECMO and inotropes.After rejection therapy, PRA showed no antibodies and patient was included in HT list and had a retransplant after 16 days without complications.Summary: To the best of our knowledge, this is the firts report of antibodie-mediated rejection in heart-transplant patient with thrombotic complication after ChAdOx1 SARS-CoV-2 vaccine.Although vaccination remains the main approach of preventing SARS-CoV-2 infeccion, transplant recipients were not included in clinical trials, so its safety remains unknown in this population.More studies are needed in order to increase knowledge about vaccine outcomes in these individuals.

In the railway sector, there has been much discussion about the costs of delays to passengers and their willingness-to-pay to reduce them. However, the cost of delays in the supply side of transport markets have received far less attention (Van Oort, 2016). This paper fills several gaps in the transport and railway literature by studying the relationship between the costs of railway supply and travel time reliability. First we articulate a generic theoretical framework for the relationship between costs and quality in railways, building on past contributions in other sectors and bringing together diverse and currently disconnected literatures. A key new element of the framework is the explicit introduction of the concepts of 'marginal proactive cost' and 'marginal reactive cost'. Second, through the lens of this framework, we empirically study the relationship between the cost of passenger train operation companies (TOCs) in Great Britain (2011 to 2015) and the reliability of their services, thus producing the first estimates in the literature of the elasticity of train operating company cost with respect to train delays, and in turn marginal cost of reducing delays. We find that for most TOCs improving quality is costly but, for some, quality improvements would be associated with lower costs overall, indicating that some operators are on a sub-optimal portion of the cost-quality curve. The framework and analysis can be used to aid quality related decisions in the railways including the design of incentive regimes; and can also be applied to other cost-quality contexts, in and outside transportation.

Scientific discoveries never appear on green fields in isolation; knowledge generated by others underpin them. But how can we foster collaborative environments, and what are the key components of success, particularly after years of digital transformation in the life science sector? This report demonstrates that access to open, free resources, such as data and software, is the underlying basis for breakthrough discoveries, scientific excellence and entrepreneurial endeavours. Studying three different European innovation ecosystems – Cambridge, Berlin and Barcelona –, the report explores the factors and actors that contribute to the success of these ecosystems. For example, it examines entrepreneurs that bridge academia and industry, companies that use open resources, and public infrastructure providers that engage in public-private partnerships. The report also features case studies of two innovation-driven European SMEs, Scailyte and SciBite , each with a different business model and use of open data.

In 2012, the Digital Universe Study reported that 'less than 1% of the World's data is analyzed and less than 20% is protected' and recommended that management plans were needed to harness the potential within these data streams (Gantz and Reinsel, 2012).Life science is a data science that is dependent on the generation, sharing and integrative analysis of vast quantities of digital data.However, these data are complex and fragmented, creating a significant barrier to their integration and reuse.Data are generated for different research purposes at thousands of facilities across the world, with diverse formats, annotations, methodologies and metadata standards.Interpreting this data is difficult and often involves integrating very large datasets from multiple sources.Certain data types such as sensitive human data archived under controlled access require protection, so data federation and sharing are a challenge in this context (Saunders et al., 2019).Since its official launch in December 2013, ELIXIR (https:// elixir-europe.org/), the European infrastructure for life science data, has worked to address these challenges by bringing Europe's national centers and core bioinformatics resources into a single, coordinated infrastructure.Many European countries have longestablished national bioinformatics infrastructures that provide tools, data resources and cloud services to national and international users.ELIXIR invests in and aims to sustain these vital resources and ensure a level of interoperability that facilitates scientific discovery.Indeed, for research to thrive in a world of data abundance, all components (research data, analysis tools, standards as well as computational resources and training materials) must be FAIR-findable, accessible, interoperable and reusable (Wilkinson et al., 2016).ELIXIR supports European life scientists in making data FAIR, ensuring that the benefits extend far beyond those actively participating in ELIXIR, and, additionally, encourages all funders to adopt Open Science mandates.Here, we describe how ELIXIR has evolved to be an established research infrastructure, with a review of significant milestones achieved, and a look into the future.By linking national networks that span most of Europe's major research centers ELIXIR is in a unique position to drive the transformation of life science's distributed data resources within Europe to be sustainable, federated, standards-based and cost-effective.

The prevalence of abnormal liver test results in the general population is estimated to be between 10% and 20%. The terms liver tests or liver chemistries are recommended to describe more accurately the tests used to assess liver health, instead of the term liver function tests. Defining normal ranges for liver transaminase levels can be challenging. Levels are affected by factors such as body mass index and sex. Elevated transaminase levels are associated with increased risks of liver-related and all-cause mortality. Patient with signs or symptoms of liver disease or abnormal liver test results should be evaluated to determine the etiology. For patients with abnormal liver test results, the initial evaluation should include a review of previous laboratory test results, medical and family histories, substance use, and drugs, including over-the-counter drugs and herbal supplements. Physical examination results often are normal but findings may be consistent with acute disease. Tests should include a complete blood cell count; alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, total bilirubin, and albumin levels; prothrombin time; hepatitis B surface antigen; hepatitis B core antibody; hepatitis C antibody; ferritin and iron levels and transferrin saturation; and right upper quadrant abdominal ultrasonography. Additional tests and imaging should be based on patient-specific risk factors and the pattern of abnormal liver test results.

Cirrhosis is pathologic scarring of liver tissue that leads to impaired liver function. It can result from any etiology of chronic liver inflammation and causes significant disease burden. Cirrhosis potentially is reversible through management of the cause, such as nonalcoholic fatty liver disease, viral hepatitis, or alcohol use. As liver disease progresses, compensated (ie, asymptomatic) cirrhosis may decompensate, causing ascites, hepatic encephalopathy, or variceal bleeding. Cirrhosis typically is diagnosed with a history, physical examination, and noninvasive testing, which includes laboratory tests, combination scoring indices, and imaging (eg, ultrasonography, transient elastography). Liver biopsy remains the reference standard for diagnosis. It should be used when results of noninvasive evaluation are indeterminate, when the etiology of liver disease remains unknown, or when the result may alter management. Clinicians should counsel patients about alcohol use, obesity management, and prevention of infection. Drugs with potential for hepatotoxicity should be avoided. Clinical assessment with laboratory tests and calculation of the Child-Pugh and Model for End-stage Liver Disease (MELD) scores should occur every 6 months. Clinicians should evaluate for and manage cirrhosis-related complications, including hepatocellular carcinoma, ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, esophageal varices, and other complications. Evaluation for liver transplantation is indicated for patients with a MELD score of 15 or greater, complications of cirrhosis, or hepatocellular carcinoma.

Britain has taken reform of the rail sector further than any other country, with complete separation of infrastructure from operations and privatisation of all train operations, using franchising in the case of passenger services. Great efforts have been made to ensure a competitive market for franchises, and to incentivise franchisees to achieve high quality services. A comparator model is used in the franchising process, and particularly on those occasions when direct awards are made, but this is based solely on the costs of the incumbent. Arguably a benchmarking approach using all passenger train operators would yield a more appropriate comparator, by examining industry best practice rather than just the incumbent. Regarding the infrastructure manager, the Regulator is responsible for determining what the efficient costs should be. More use of benchmarking has been made, both using top down econometric methods and bottom up in depth studies of particular issues. Initially top down methods were applied using international comparisons, but there are problems in getting comparable data and dealing with heterogeneity. More recently, efforts have concentrated on internal benchmarking between the different Network Rail routes and increased devolution of responsibilities to routes and regions has made this more useful. Whilst quality measures do not directly enter the benchmarking framework, the infrastructure manager faces a number of regulatory incentive and targeting mechanisms aimed at ensuring good performance and condition of the infrastructure. Despite these efforts, there is dissatisfaction with increasing costs both of infrastructure and train operations and with quality of service, especially reliability. Further changes are expected following a review led by Keith Williams, including a new body more closely integrating infrastructure and services, and a move to more use of concessioning services on gross cost contracts.

In this paper, we combine engineering and economic methods to estimate the relative maintenance cost of different types of damage on the Swedish rail infrastructure. The engineering method is good at predicting damage from traffic, while the economic method is suitable for establishing a relationship between damage and cost. We exploit the best features of both methods in a two-stage approach and demonstrate its applicability for rail infrastructure charging, based on a sample of 143 track sections comprising about 11,000 km of track. The paper implements for the first time the method previously proposed in Smith et al., whilst also enhancing the method in several respects. We demonstrate how the estimated relative maintenance costs related to different damage mechanisms can be used to calculate the marginal cost of different vehicle types. The results are relevant for infrastructure managers in Europe who wish to differentiate their track access charges such that each vehicle pays its short run-marginal damage cost, which can support more efficient use of the rail infrastructure and influence vehicle design to minimize system costs.

Although Chinese Railways remains largely a government owned vertically integrated system, track access charges were implemented for passenger trains in 2005 and freight trains in 2017. In recent years, many joint venture railway companies and local railway companies have been set up to bring in funding from provincial governments, state-owned enterprises and private enterprises for the construction of new lines. The coexistence of different railway enterprises and the interconnected characteristic of the railway network make the proportion of inter-rail company traffic for both passenger and freight high in China. Therefore, Chinese railways have adopted a series of revenue/cost settlement regimes reforms, including new rail access charges regimes. This paper examines these reforms, finding that the current Chinese access charges are still mainly a way to balance the accounts of rail companies. Given the revenue model of joint venture railway companies in China, the level of rail access charges is crucial for their financial performance. Moreover, the Chinese government has announced its intention of permitting open access competition, so the level and structure of track access charges will become much more important in future. Finally, this paper produces recommendations about how to reform the Chinese rail access charges regime for better adapting to the market needs in the future, in the light of European and Japanese experience.