Diana Mance

Stable isotope analysis of the karst hydrological systems in the Bay of Kvarner (Croatia)

Here we present the results of the first systematic analysis of the stable isotope composition of the karst hydrological systems in the Bay of Kvarner. Gaussian mixture modelling, time series analysis and autoregressive integrated moving average (ARIMA) modelling were applied using the stable isotope compositions of the karst groundwater. This study revealed that the recharge is dominated by winter precipitation, the dual-porosity system is dominated by baseflow, the hinterlands of the individual springs have different degrees of karstification and the springs within the Rječina River catchment have higher recharge elevations than the springs in the Bakar Bay catchment.

Characterization of the Gacka River basin karst aquifer (Croatia): hydrochemistry, stable isotopes and tritium-based mean residence times.

The Gacka River basin aquifer is a highly-developed karst system, located in the Croatian Dinarides. It is mostly composed of permeable Jurassic and Cretaceous carbonate rocks, and clastic sedimentary rocks of Paleogene age. Gacka River provides high quality water for the town of Otočac and several villages; together with the neighboring Lika River, the water is used for the Hydroelectric Power Plant at Senj on the coast. About 10 perennial and over 20 seasonal springs are located at 450 to 460 ma.s.l. (above sea level). Three major springs (Pećina, Majerovo and Tonkovića) provide 57% of the mean annual river flow. Similarities between the average groundwater temperatures as well as between the average specific electrical conductivity values (9.0°C-328 μS/cm, 9.6°C-350 μS/cm and 8.9°C-312 μS/cm) of the springs imply that they are fed from aquifers with similar mean residence times (MRTs). The mean δ(18)O contents of Majerovo, Tonkovića, and Pećina are around -10.1‰, -9.2‰ and -8.9‰, respectively, revealing differences in the mean recharge area elevations. Compared to the temporal amplitude of the(18)O signal of precipitation, the (18)O signal variations of the springs are substantially attenuated because the recharges occurring at different times are well mixed within the aquifers. This indicates MRTs of more than just a few years. The average tritium contents of Pećina, Majerovo and Tonkovića are 5.48 TU, 6.13 TU and 6.17 TU, respectively. Serially connected exponential-plug type unsteady lumped-parameter models run on an annual time scale resulted in rather satisfactory matches between the observed and calculated tritium contents for all studied springs. The models revealed similar MRTs (and corresponding reservoir volumes) for Pećina, Tonkovića and Majerovo of 12 years (470 Mm(3)), 12 years (1,190 Mm(3)), and 12.2 years (1,210 Mm(3)), respectively. Plug flow conditions dominate in about 90% of the total aquifer volumes.

Incremental cost-effectiveness pharmacoeconomic assessment of hepatitis C virus therapy: an approach for less wealthy members of the common market

Aim To develop a new method of health-economic analysis based on a marginal approach. Methods We tested the research hypothesis that a detailed comparative a priori incremental cost-effectiveness analysis provides the necessary input for budget impact analysis about the proper order of introduction of new therapies, and thus maximizes the cost-effectiveness bounded by the total budget constraint. For the analysis we chose a combination therapy for the treatment of hepatitis C virus (HCV) genotype 1 (GT1) infection, which was approved by the European Medicine Agency in 2015. We used the incremental cost-effective approach to assess the increase in the percentage of patients achieving sustained virological response (SVR) and the expenditure per additional SVR modulated by the new therapys market entrance dynamics. Patient subpopulations were differentiated by their response to previous treatment, presence of cirrhosis, and HCV GT1 subtype. Final parameters were estimated by Monte Carlo simulations. Results The new combination therapy had high efficacy, shorter duration, and was better tolerated than alternative interventions. The research hypothesis was confirmed: gradual introduction of the new therapy on the market, based on a priori incremental cost-effectiveness analysis, would result in average increase in successfully treated patients by 20%-40%, while additional costs would approximately be between 8%-40%, ie, €21,000-52 000 per additional patient achieving SVR. Conclusion We showed the new combination therapy to be cost-effective for certain patient subpopulations, especially for experienced cirrhotic HCV GT1 patients. Results of the analysis are in agreement with the latest recommendations for HCV patients’ treatment in Croatia. This economic evaluation could serve as a starting point for negotiations between pharmaceutical industry and insurance companies.

EconomEtric AnAlysis of croAtiA's ProclAimEd forEign ExchAngE rAtE

Abstract The officially proclaimed foreign exchange policy of the Croatian National Bank (CNB) is a managed float with a discretionary right of intervention on the Croatian kuna/euro foreign exchange (FX) market in order to maintain price stability. This paper examines the validity of three monetary policy hypotheses: the stability of the nominal exchange rate, the stability of exchange rate changes, and the exchange rate to inflation pass-through effect. The CNB claims a direct FX to inflation rate pass-through channel for which we find no evidence, but we find a strong link between FX rate changes and changes in M4, as well as between M4 changes and inflation. Changes in foreign investment Granger cause changes in monetary aggregates that further Granger cause inflation. Changes in FX rate Granger cause a reaction in M4 that indirectly Granger causes a further rise in inflation. Vector Autoregression Impulse Response Functions of changes in FX rate, M1, M4, and CPI confirm the Granger causalities in the established order.