The COVID-19 pandemic has expanded globally and caused serious consequence in both health system and the economy. MPV is one of two oral antivirals for COVID-19 with mild-to-moderate symptoms that have received FDA approval so far. This study aims to evaluate the cost-utility of using MPV in COVID-19 treatment. To compare the utility costs of MPV and non-MPV treatments for COVID-19 patients, we used a decision tree model. Data on clinical efficacy, cost, and quality of life were gathered from previous studies. The incremental effective cost ratio (ICER) calculated based on costs incurred and quality-adjusted life years (QALY), was considered as primary out-come. The total cost of MPV treatment and not using MPV was 15,362,516 VND (618 USD) and 15,771,262 VND (634 USD), respectively. The estimated QALY with using-MPV was 28.33, while without MPV was 19.72. The ICER was dominant, resulting in savings of 47,453 VND/QALY (1.9 USD). MPV is a cost-effective medication used to treat COVID-19. In mild-to-moderate COVID-19 patients, MPV considerably lowers costs and improves quality of life. However, several clinical factors of the drug still need to be taken into account.

Background: Stoma closure is a widely performed surgical procedure, with 6295 undertaken in England in 2018 alone. This procedure is associated with significant complications; incisional hernias are the most severe, occurring in 30% of patients. Complications place considerable financial burden on the NHS; hernia costs are estimated at GBP 114 million annually. As recent evidence (ROCSS, 2020) found that prophylactic meshes significantly reduce rates of incisional hernias following stoma closure surgery, an evaluation of this intervention vs. standard procedure is essential. Methods: A cost-utility analysis (CUA) was conducted using data from the ROCSS prospective multi-centre trial, which followed 790 patients, randomly assigned to mesh closure (n=394) and standard closure (n=396). Quality of life was assessed using mean EQ-5D-5L scores from the trial, and costs in GBP using UK-based sources over a 2-year time horizon. Results: The CUA yielded an incremental cost-effectiveness ratio (ICER) of GBP 128,356.25 per QALY. Additionally, two univariate sensitivity analyses were performed to test the robustness of the model. Conclusion: The results demonstrate an increased benefit with mesh prophylaxis, but at an increased cost. Although the intervention is cost-ineffective and greater than the ICER threshold of GBP 30,000/QALY (NICE), further investigation into mesh prophylaxis for at risk population groups is needed.

Osteoarthritis (OA) is the degeneration of cartilage in joints that results in bones rubbing against each other, it causes uncomfortable symptoms such as pain, swelling, stiffness, and can lead to disability. It usually occurs in the elderly and causes a large medical burden. The aim of this study is to evaluate cost-effectiveness between the standard treatment for osteoarthritis and the standard treatment with added crystalline glucosamine sulfate at various stages. The Markov analysis modelling was applied to evaluate the effect of both adding glucosamine compared to standard treatment from a societal perspective during whole patients’ lifetimes. Data input was collected by review in previous studies. The outcome was measured in quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER) from a societal perspective was ap-plied with 3%-discounted for all cost and outcome. One-way analysis via Tornado diagram was performed to investigate the change of factors in model. In general, the adding glucosamine into the standard treatment proved to be more cost-effectiveness compared to the standard treatment. Particularly, early stage adding glucosamine in the treatment was cost-effectiveness then post-stage adding glucosamine. The addition of supplementing crystalline glucosamine sulfate to whole regimen at any stage was cost-effectiveness at willingness-to-pay (WTP) threshold

The pollution of the bays in Abidjan is a major concern for the Ivorian policy makers. In fact, the pollution of the bays induce high costs to the society while impacting population health dramatically. As a result, pollution reduction management of production activities has been undertaken in the Cocody Bay area. To our knowledge, no study has yet proposed a model to evaluate the cost-effectiveness of these pollution management strategies. A cost-effectiveness model, based on Monte Carlo simulation, was developed to assess the economic and environmental impacts of various scenarios characterized by a set of production practices, both in the short term and in the long term. The authors discuss the steps and input parameters of the model presented. The proposed model may serve as the basis for identifying an optimal production scenario defined as the scenario with the best incremental cost-effectiveness ratio considering a willingness to pay (WTP) threshold. The WTP, to be estimated based on the gross domestic product of Côte d’Ivoire, represents the opportunity costs associated with selecting the optimal scenario. The current framework can also be applied to other settings facing similar challenge.

Users of meteorological forecasts are often faced with the question of whether to make a decision now based on the current forecast or whether to wait for the next and hopefully more accurate forecast before making the decision. One would imagine that the answer to this question should depend on the extent to which there is a benefit in making the decision now rather than later, combined with an understanding of how the skill of the forecast improves, and information about the possible size and nature of forecast changes. We extend the well-known cost-loss model for forecast-based decision making to capture an idealized version of this situation. We find that within this extended cost-loss model, the question of whether to decide now or wait depends on two specific aspects of the forecast, both of which involve probabilities of probabilities. For the special case of weather and climate forecasts in the form of normal distributions we derive a simulation algorithm, and equivalent analytical expressions, for calculating these two probabilities. We apply the algorithm to forecasts of temperature and find that the algorithm leads to better decisions relative to three simpler alternative decision-making schemes. Similar problems have been studied in many other fields, and we explore some of the connections.

Background: Significant national and global costs were incurred from recent emerging infectious disease outbreaks, notably H1N1 highly pathogenic influenza, Zika and Severe Acute Respiratory Disease (SARS), both in the medical sphere and within the socioeconomic context around it. With forecasts expecting an increase in direct and indirect burden of novel infectious disease events, costs of future outbreak events are likely to be exacerbated. In this scope, it is critical for countries to identify this trend and work towards minimizing costs while continuing to improve prevention, treatment and mitigation. Objectives: The impacts of the West Africa Ebola crisis have largely focused on the response to the outbreak abroad. The aim of this paper was to determine the direct and indirect domestic costs of the Ebola Virus Disease (EVD) introduction into the United States (U.S.), compare the economic consequences of the epidemic with other disease outbreaks and identify the primary drivers of such costs to leverage more global health preparation to prevent, prepare for, and respond to disease threats more effectively. Methods: I conducted a literature review of 1) EVD cases documented by the U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO), 2) scientific articles identifying the costs of Ebola for the U.S. and countries around the world and 3) grey literature on treatments and public reactions. Extrapolating data from these sources, I then performed a cost-analysis of direct costs (preparation, treatment and contact tracing) and indirect costs (loss of productivity owing to disease, death, and risk avoidance behaviors) of the disease. Findings: The country spent between $300-$700 million in direct costs. Additionally, roughly $200-$340 million were forgone as results of loss of productivity from to disease, death or social risk avoidance behaviors. The cost-per-case for the United States was vastly higher than for any other country. Conclusions: High direct costs suggest that either the United States took disproportionate preparative measures to mitigate a potential American outbreak or were unprepared for a potential outbreak of this magnitude. The significant risk avoidance behavior estimates hint that forces having the ability to shape social attitudes and norms – namely traditional and online media – played a significant role in driving social behavior towards fear of exposure to others. The findings reinforce that outbreaks occurring in a single part of the world can have dramatic economic effects globally, even in areas with existing public health capacity and other preventive measures, highlighting the need for change in global health systems to shift from a passive responder and incorporate other societal actors to effectively reduce the ever-increasing costs of disease threats.

The purpose of this research is to determine if the tradeoffs that Kissick proposed among cost containment, quality, and access remain as rigidly interconnected as originally conceived in the contemporary health care context. Although many have relied on the Kissick model to advocate for health policy decisions, to our knowledge, the model has never been empirically tested. Some have called for policy makers to come to terms with the premise of the Kissick model tradeoffs, others have questioned the model given the proliferation of quality enhancing initiatives, automation, and information technology in the health care industry. One wonders whether these evolutionary changes alter or disrupt the originality of the Kissick paradigms themselves. Methods: Structural Equation Modeling (SEM) was used to evaluate the Kissick hypothetical relationships among the unobserved constructs of cost, quality, and access in hospitals for the year 2018. Hospital data were obtained from Definitive Healthcare a subscription site which contains Medicare data as well as non-Medicare data for networks, hospitals, and clinics (final n= 2,766). Results: Reporting significant net effects as defined by our chosen study variables, we find that as quality increases costs increase, as access increases quality increases, and as access increases, costs increase. Policy and Practice Implications: Our findings lend continued relevance to a balanced approach to health care policy reform efforts. Simultaneously bending the health care cost curve, increasing access to care, and advancing quality of care is as challenging now as it was when the Kissick model was originally conceived.

Dealing with randomness is a crucial aspect that cost-effectiveness analysis (CEA) tools need to address, but existing stochastic CEA tools have rarely examined risk and return from the perspective of global benefits. This paper proposes a stochastic CEA tool that supports medical decision-making from the perspective of global benefits of risk and return, the risk-adjusted incremental cost-effectiveness ratio (ICER). The tool has a traditional form of ICER but uses the risk-adjusted expected cost. Theoretically, we prove that the tool can provide marginal medical decisions that promote the risk-return level on global benefits within any intervention structure and can also serve as a discriminating condition for the optimal intervention structure. Numerical simulations within a framework of mean-variance support the conclusions in this paper.

A mathematical model that incorporates human attacks on dogs is presented to explore the dynamics of rabies transmission. The model divided the infection rate into two categories: dog-to-dog transmission rates during the prodromal phase (βdP) and the furious phase (βdF). It has been determined that the model is well-posed and that all of the solutions are positive, as well as the feasibility and positivity of the model's solutions. Both the basic reproduction number (R0) and the effective reproductive number (Re) are computed, and it is demonstrated that the model has a unique disease-free equilibrium that is globally asymptotically stable whenever Re < 1. To identify the model's most sensitive parameters and the ones that intervention efforts should focus on, sensitivity analysis of the effective reproduction number is carried out. We can construct an optimal control system using the state equations, the adjoint equations, and the optimality condition that determines the controls by applying Pontryagin's Maximum/Minimum principle. To help decision-makers in allocating funds for rabies interventions, cost-effectiveness analyses are conducted. To determine the degree to which the intervention strategies are advantageous and cost-effective, this study performs a cost-effective analysis of one or all possible combinations of the optimal rabies control strategies (pre-exposed and post-exposed vaccination for both dog and human populations) for the four different transmission settings. After arranging the techniques to increase effectiveness (total infections prevented), a cost-effective analysis using the Incremental Cost Effectiveness Ratio (ICER) was conducted. The result supports the function that the four intervention options are performing to either completely eradicate or significantly reduce rabies disease among the populations. The dynamical behavior of the system is studied through simulations using the ode45 numerical technique from MATLAB.

We report a very frugal microscope building method from easily realizable parts. We show a highly portable field ready compound type microscope with bright field, dark field and projection microscopy capabilities. It has good resolution and magnification for multiple aspects of education and diagnosis. We demonstrate that such a system can be built from simple lenses in laser pointers and camera modules with no specific 3d printed parts or costly lenses. We show all the parts of the system like stage, coarse and fine focussing system, microscope body, even slides can be built from commonly available materials like soda bottle and DVD disks. We list alternate, safer and easily available staining methods and chemicals. The microscope is developed with a target that it can be self-developed even in rural areas of the world with only resources at one’s disposal with very little education. This features a stable focussing and panning system for comfortable viewing through eyes and also easy imaging with a smartphone. We show its utility for microorganism analysis and potential for clinical diagnosis.

The growing demand for clean energy transitions has become increasingly significant, with solar energy emerging as one of the most prominent clean energy resources contributing to this effort. However, there remains limited knowledge regarding the economic feasibility of solar project development across different geographic locations and scales. This study introduces a comprehensive economic analysis framework to assess the economic viability of residential and utility-scale solar projects, using California, Tennessee, and Texas as case studies. The economic assessment is conducted through a cost-benefit analysis that adopts a full life-cycle approach, encompassing phases from permitting to demolition for both scales of solar projects. We found that utility-scale solar projects generally offer more favorable investment return ratios compared to residential projects, despite the absence of land acquisition costs and lower initial capital expenditures for the latter. Furthermore, the incorporation of energy storage solutions, such as Battery Energy Storage Systems (BESS), is shown to be essential for improving the efficiency of residential solar energy usage, with efficiency gains of up to 50%. Finally, region-specific strategies, including net metering policies, electricity retail market structures, and the promotion of solar adoption, play a crucial role in enhancing the financial viability of solar projects for both residential and utility scales.

(1) Background: AI technology has been deeply applied to online shopping platform to provide more accurate and personalized services for consumers. It is of great significance to study the different functional experience of AI for consumers to improve the current application status of AI technology.(2)Method: Based on the "S-O-R" model, this study divided the AI technology expe-rienced by the consumers of online shopping platform into accuracy, insight and interaction experience. Takes the perceived value as the mediating variable from the prospect of perceived utility value and perceived hedonic value. This article use empirical research method to analyze the effect of three dimensions of online shopping AI experience to research the internal influence mechanism of consumers purchase intention. (3) Results:① The accuracy, insight and interaction experience of AI marketing technology have a significant positive impact on consumers' per-ceived utility value and hedonic value respectively; ②Both of the perceived utility value and perceived hedonic value obtained by AI technology experience can promote the formation of consumers' purchase intention; ③ The perceived hedonic value was better than perceived utility value to promote the consumers' purchase intention; ④The results of multi group analysis show that some younger and less experiences consumers groups prefer the pleasure experience such as shopping desire stimulation, shopping process relaxation and pleasure that AI marketing brought. However, utilitarian value cannot promote this kind of consumers' purchase intention. (4) Con-clusions: Perceived utility value and perceived hedonic value can be the intermediary between AI technology and consumers' purchase intention.

Objective: To evaluate the direct costs of treating patients with neuromyelitis optica spectrum disorders (NMOSD) in outpatient care, from a hospital and Unified Health System (SUS) perspective. Methods: Observational study with data collection by microfunding, carried out with patients diagnosed with neuromyelitis optics, treated at a university hospital, in the city of Rio de Janeiro. Mann-Whitney tests were performed to measure cost differences between patient groups by disease severity and analysis perspective. Results: Nine individuals with a median age of 48 years (IQR 30 - 59 years) were included. The median total costs for patients with greater severity from the perspective of the SUS and the hospital were R$ 21,638.22 (IIQ: R$ 15,614.63; R$ 25,985.32) and R$ 32,094.11 (IIQ: R$ 25,610 .60; R$ 38,617.25) respectively. For patients with moderate severity the median was R$ 7,339.85 (IIQ: R$ 6,235.45; R$ 11,912.05) from the SUS perspective and R$ 11,505.80 (IIQ: R$ 7,339.85; R$ 22,424.76) from the perspective of the hospital, where the use of medications had a major impact. Conclusion: The main cost drivers were medicines, especially those used off-label, and procedures.

With the pressure of the increasing density of urban areas, some public infrastructures are moving to the underground to free up space above, such as utility lines, rail lines and roads. In the big data era, the three dimensional (3D) data can be beneficial to understand the complex urban area. Comparing to spatial data and information of the above ground, we lack of the precise and detailed information about underground infrastructures, such as the spatial information of underground infrastructure, the ownership of underground objects and the interdependence of infrastructures in the above and below ground. How to map reliable 3D underground utility networks and use it in the land administration? First, to explain the importance of this work and find a possible solution, this paper observes the current issues of the existing underground utility database in Singapore. A framework for utility data governance is proposed to manage the work process from the underground utility data capture to data usage. This is the backbone to support the coordination of different roles in the utility data governance and usage. Then, an initial design of the 3D underground utility data model is introduced to describe the 3D geometric and spatial information about underground utility data and connect it to the cadastral parcel for land administration. In the case study, the newly collected data from mobile Ground Penetrating Radar is integrated with the existing utility data for 3D modelling. It is expected to explore the integration of new collected 3D data, the existing 2D data and cadastral information for land administration of underground utilities.

Abstract: Peptide pools composed of short amino acid sequences have proven to be versatile tools in various research areas and clinical applications. They are powerful tools for epitope mapping, immunotherapy, and vaccine development. Their importance lies in their ability to map complex protein structures, enabling a comprehensive understanding of immune responses and facilitating the identification of potential therapeutic agents. The application of peptide pools also extends to the field of personalized medicine, offering tailored solutions for diseases such as cancer and infectious diseases. Peptide pools are complex mixtures of immunostimulatory antigens primarily intended for T-cell stimulation. They are commercially available in many different compositions and variants. However, unlike other reagents that consist of only one or a few compounds, peptide pools are highly complex products with limited stability. This makes their quality control a major challenge. Quantitative peptide analysis usually requires sophisticated methods, in most cases isotope-labeled standards and reference materials. None of these are routinely available for these products. Synthesis and purification of all labeled peptides might be required. Usually, this approach would be prohibitively laborious and expensive. Therefore, an approach is needed to provide a practical and feasible method for quality control of peptide pools. With insufficient quality control, the use of such products could lead to incorrect experimental results, which would worsen the well-known reproducibility crisis in the biomedical sciences. Here we propose the use of ultra-high performance liquid chromatography (UHPLC) with two detectors, a standard UV detector (at 214 nm) for quantitative analysis and a high-resolution mass spectrometer (HRMS) for identity confirmation. To be cost-efficient and fast, quantification and identification are performed in one chromatographic run. An optimized protocol is shown, and different peak integration methods are compared and discussed. This work was performed using a peptide pool known as CEF, which consists of 32 peptides derived from cytomegalovirus (CMV), Epstein-Barr virus (EBV) and influenza virus, ranging from 8 to 12 amino acids in length.

A techno-economic model was developed to investigate the influence of components on the system costs of redox flow batteries. Sensitivity analyses were carried out based on a example of a 10 kW/120 kWh vanadium redox flow battery system and the costs of the individual components were analyzed. Particular consideration was given to the influence of material costs and resistances of bipolar plates and energy storage media as well as voltages and electric currents. Based on the developed model it was possible to formulate statements about the targeted optimization of existing battery systems and general aspects for future developments of redox flow batteries.

A disaster wrecks those affected. It spares many in the affected areas, yet those spared may be indirectly impacted. Specific risks are often inherent within a social system or physical location, but they can also be created due to unavoidable natural or technological hazards. The consequences, however, can be similar in that they wreak havoc in communities and destroy economic systems. The analytical framework of deterrence and coping has ascertained beneficial in many circumstances, but a cost benefit calculation is a must to infer the feasibility of planning strategy and resource allocation. This study points to the Cost-Benefit Analysis (CBA) of flood management by District Disaster Management Kulgam. The assessment is established on secondary pooled data collected from administration offices, NGOs, published Journals, and local and national newspapers. It also characterised the strategy, the technique adopted, and the sources of flood damage cost information. The totalled benefits report for 78686.18 lakh of rupees, and that of total costs account for 2218.75lakh of rupees. The Benefit-Cost ratio greater than one (>1) indicates that Flood Management in District Kulgam was economically feasible and successfully governed. The State of Jammu and Kashmir put up with necessary prevention and administration measures to break the spell of devastation due to floods to significant status.

Most pathologies in emergency departments(EDs) can be detected with using non-invasive, extremely safe magnetic resonance imaging (MRI). MRI is highly sensitive to abnormality, so when compared to Computed Tomography(CT), a negative MRI far exceeds the value of a negative CT. This was a retrospective cohort study comparing resource utilization between September 2016 and September 2017 in a university hospital ED. Descriptive statistics are presented with frequency, percentage, mean, standard deviation, minimum and maximum values. A chi-square analysis was conducted to examine the relationships. Analyses were conducted using the SPSS 22.0 package program. In the ED, MRI is available 24/7. MRI was performed on 954 (479 female, 475 male) patients. A total of 212 cranial, 604 diffusion, 57 lumbar, 40 cervical, 38 dorsal, two abdominal, and one orbital MRIs were performed. In most groups, the average age was over 40, and the age distribution was similar (p = 0.12). There was no significant sex difference except for lumbar MRI. Lumbar MRI and diffusion MRI groups were admitted to the hospital mostly in the day hours (p = 0.03); in other groups, night and day admissions were almost the same. Neuroimaging takes the majority part of MRI examinations in our ED.

With a data revolution underway for some time, there is an increasing demand for formal privacy protection mechanisms that are not so destructive. Hereof microaggregation is a popular high-utility approach designed to satisfy the popular k-anonymity criteria while applying low distortion to data. However, standard performance metrics are commonly based on mean square error, which will hardly capture the utility degradation related to a specific application domain of data. In this work, we evaluate the performance of k-anonymous microaggregation in terms of the loss in classification accuracy of the machine learned models built from perturbed data. Systematic experimentation is carried out on four microaggregation algorithms that are tested over four data sets. The empirical utility of the resulting microaggregated data is assessed using the learning algorithm that obtains the highest accuracy from original data. Validation tests are performed on a test set of non perturbed data. The results confirm k-anonymous microaggregation as a high-utility privacy mechanism in this context and distortion based on mean squared error as a poor predictor of practical utility. Finally, we corroborate the beneficial effects for empirical utility of exploiting the statistical properties of data when constructing privacy preserving algorithms.

In this study we were interested in the behaviors of individuals who preserve the social and organizational environment by ensuring sustainability. More specifically we are interested in allegiants behaviors. Numerous studies have highlighted the normative character of allegiance. To confer an object the status of social norm means to assign value (in terms of desirability and utility) to that object. Therefore we questioned the value attributed to allegiance. 170 employees were questioned on the desirability and utility they attribute to a future work colleague (future peer or future subordinate) starting from the answers the latter was supposed to have given to a questionnaire on allegiance. It was observed that desirability and utility make reference to two independent dimensions, utility being often more important. It was also noted there is greater severity assigned to endo-group targets (future peers) than to exo-group targets (future subordinates). Finally, it was noted there was not so much a valuation of allegiant targets, but rather a rejection of rebel targets, which raises the question of the bi-dimensionality of the valuation-devaluation process.

In small-scale hydropower scheme, the most important component is electro-mechanical equipment. Since cost contribution of this component is high because hydrokinetic projects require negligible civil works. Turbine and alternator contribute major fraction of the hydrokinetic projects. Thus, there is a requirement to estimates the electromechanical equipment cost for the hydrokinetic hydropower scheme. The present paper investigates design parameters of the hydrokinetic turbines and intends to develop cost correlation which depends on most critical parameters of hydropower sites such as velocity and power capacity. In this present work, three zero head turbines are considered including straight blade Darrieus, two Stage Savonius, and Gorlov Helical. The size and cost of major components have been calculated based on material, manufacturing, research and design, and assembly costs. Based on cost and site parameters, cost correlation has been developed. The obtained cost has been validated with available zero head turbines in the market and installed projects. A techno-economic analysis has been carried out to select economical hydrokinetic turbine for river and canal application.

In this study, the probabilistic exergoeconomic analysis was performed for four industrial gas turbine (GT) units comprising of two (GT16 and GT19) units of 100MW GE engine and two (GT8 and GT12) units of 25MW Hitachi engine at Transcorp Power Limited, Ughelli. These four industrial GT engine units were modelled and simulated using natural gas as fuel. The design point (DP) simulation results of the modelled GT engines were validated with the available DP thermodynamic data from original equipment manufacturer (OEM). This was done before the off-design point (ODP) simulation was carried out which represents the plant operations. The results obtained from exergy analysis at full load operation show that the turbine has the highest exergy efficiency followed by compressor and combustion having the least. For turbines these were 96.13% for GT8 unit, 98.02% for GT12 unit, 96.26% for GT16 unit, and 96.30% for GT19 unit. Moreover, the combustion chamber has the highest exergy destruction efficiency of 55.16% GT8 unit, 56.58% GT12 unit, 43.90% GT16 unit, and 43.30% GT19 unit respectively. The exergy analysis results obtained from the four units show that the combustion chamber (CC) is the most significant exergy destruction with lowest exergy efficiency and highest exergy destruction efficiency of plant components. The exergoeconomic analysis results from four units showed combustion chamber energy destruction cost of 531.08 $/h GT8 unit, 584.53 $/h GT12 unit, 2351.81$/h GT16, and 2315.93$/h GT19 unit. The probabilistic results analysis based on the input parameters distributions evaluated and discussed.

Pneumococcal disease, caused by Streptococcus pneumoniae is the leading cause of high mortality in children worldwide. The tremendous direct cost of hospital admissions and significant indirect costs from productivity loss contributed considerably to the economic burden, with vaccination being the only efficient way against the illness. Our study aims to summarize the cost-effectiveness of the pneumococcal conjugate vaccine (PCV) implemented in the pediatric population. Employing online databases from Pubmed, Embase, and Medline, we looked for economic evaluation from 2018 until March 2024. The Incremental Cost-Effectiveness Ratios (ICER) and Quality-Adjusted-Life-Years (QALY) were the primary outcomes for measuring PCV's cost-effectiveness. A 28-item CHEERS 2022 checklist was applied to assess the quality of collected studies. Of the 16 papers found, 9/16 discussed the lower-valent vaccine (PCV13, PCV10) and 7/16 examined the higher-valent vaccine. (PCV20, PCV15). PCV13 and PCV10 required more cost and generated more QALY compared to no vaccination. Both PCV15 and PCV20 averted substantial healthcare costs and yielded greater quality of life than PCV13. Additionally, PCV20 was a dominant strategy compared to PCV15. Utilizing PCV13 is a very cost-effective option compared to not getting vaccinated. Transitioning from PCV13 to PCV20 would result in higher QALY gain and more cost-saving than switching to PCV15.

The purpose of this study was to determine the income, costs and revenue of the Gontor Putri 3 bakery. Want to know the efficiency of the bakery business in Karangbanyu Regency. The method used in this research is analytical descriptive by conducting a survey. The data used in this research is primary data. Data collection techniques use observation, interviews and documentation, while the process of analysis is quantitative descriptive. Using the R/C ratio, a value of 1.72 per month is obtained. This value indicates that the bakery factory in Karangbanyu is efficient because the value is more than one.

We use the theory of coherent measures to look at the problem of surplus sharing in an insurance business. The surplus share of an insured is calculated by the surplus premium in the contract. The theory of coherent risk measures and the resulting capital allocation gives a way to divide the surplus between the insured and the capital providers, i.e. the shareholders.

As argued by ‘Declaration of Concrete Environment (2010)’ of Korea and ‘Declaration of Asian Concrete Environment (2011)’ of six Asian countries, concrete as a single material has lately shown extremely large impact on environmental issues such as climate change. Assessment of environmental impact from concrete material and production has considerable importance. Concrete is a major material used in the construction industry that emits a large amount of substances with environmental impacts during its life cycle. Accordingly, technologies for the reduction in and assessment of the environmental impact of concrete from the perspective of Life Cycle Assessment must be developed. At present, the studies in relation to greenhouse gas emission from concrete are being carried out globally as a countermeasure against climate change. In this study, a sustainable concrete mix design algorithm was designed using correlation analyses, and its carbon emission and cost reduction performances were assessed. Using correlation analyses, the concrete strength, w/b and s/a ratios, and CO₂ emissions were identified as major variables of concrete mix design that influenced other variables. Also, this study aims to evaluate the CO₂ emission reduction performance of the algorithm-deduced sustainable concrete mix design, and therefore, the CO₂ emissions of the sustainable concrete mix design are compared with those of the actual concrete mix design applied to the construction of the office building A in South Korea.

Global warming and CO₂ emissions have become increasingly pressing concerns, with the aviation industry contributing significantly to these issues. In response, efforts have been made to develop environmentally sustainable aviation solutions. This paper examines the Direct Operating Costs (DOC) of the Wright Spirit, one of the options for electric flight, compared to the conventional BAe 146 on which the Wright Spirit is based. Utilizing methodologies adapted from previous studies (largely the AEA method), the analysis investigates various factors influencing DOC, including battery prices, flight duration, and charging time. Results indicate a 73% increase in overall DOC from the BAe 146 to the Wright Spirit, largely influenced by battery costs and lifespan. However, an 83% reduction in fuel/energy costs suggests the potential viability of the Wright Spirit, particularly with anticipated reductions in battery prices. For instance, a quartering of battery prices could result in a £5 increase in costs for 1-hour flights, compared to the BAe 146. Moreover, the analysis finds the battery lifespan and charging time to be the most important factors to control, in order to increase commercial feasibility. Ticket price comparisons suggest that the Wright Spirit's costs align closely with current market prices, with a flight from Paris to Heathrow predicted to cost the airline £136.10 per passenger. Future research could explore alternative electric aircraft designs, to further assess their impact on DOC and ticket prices.

(1) Background: in epidemiological terms, it has been possible to calculate the savings in health resources and the reduction in health effects of COVID vaccines. From the point of view of economic evaluation, some studies have estimated its cost-effectiveness with the vaccination showing highly favorable results, which in some cases is cost-saving; (2) Methods: a cost-benefit analysis of the vaccination campaign in the North Metropolitan Health Region (Catalonia). An epidemiological model based on observational data and before and after comparison is used. The information on the doses used and the resources assigned (conventional hospital beds, ICU, number of tests) has been extracted from administrative data from the largest Primary Care provider in the region (Catalan Institute of Health). A distinction is made between the social perspective and the health system; (3) Results: the costs of vaccination are estimated at 137 million euros (€48.05/dose administered). This figure is significantly lower than the positive impacts of the vaccination campaign, which are estimated at 470 million euros (€164/dose administered). Of these, 18% corresponds to the reduction of ICU discharges, 16% to the reduction in conventional hospital discharges, 5% to the reduction in PCR tests and 1% to the reduction of RAT tests. Monetization of deaths and cases with sequelae avoided account for 53% and 5% of total savings, respectively. The benefit/cost ratio is estimated at 3.4 from a social perspective and 1.41 from a health system perspective. The social benefits of vaccination are estimated at €116.67 per dose of vaccine given (€19.93 from the point of view of the health system); (4) Conclusions: the mass vaccination campaign against COVID is cost-saving. From a social perspective, most of these savings come from the monetization of the reduction in mortality and cases with sequelae, although the intervention is equally widely cost-effective from the point of view of the health system thanks to the reduction in the use of resources. It is concluded that, from an economic perspective, the vaccination campaign has high social returns.

BACKGROUND: The National Lung Screening Trial (ILST) and the NELSON study showed that lung cancer-specific mortality can be reduced by 20-24% using low-dose computed tomography (LDCT) screening in high-risk populations, due to an increase in early-stage diagnoses. RESEARCH QUESTION: How much lung cancer-related direct costs may be reduced using a LDCT screening programme based on the ILST protocol in a public healthcare system?STUDY DESIGN AND METHODS: Cost analysis of lung cancer screening (LCS) vs. usual care in the framework of the retail price of the Catalan public healthcare system. The LCS group included costs of screening (ILST protocol), treatment cost according to weighted average distribution of TNM staging in the NLST and NELSON trials, lung cancer detection rate (CDR) and smoking cessation intervention. The usual care group included treatment costs based on distribution of TNM staging registered in the Spanish index hospital. RESULTS: In the usual care group, treatment costs were €91,959. In the 5-year duration of the LCS programme, the average expected costs per subject were €1,342 (range €1,054-1,832 depending on malignancy in detected nodules) for screening and €32,431 for treatment, with an expected reduction of €952 based on an average CDR of 1.6%. The decrease in cost resulting from stage shift offsets 70.6% of the costs of the screening programme. INTERPRETATION: Baseline 5-year LCS costs are low according to the ILST protocol. In the Catalan public healthcare system, the expense reduction from the stage shift due to the LCS programme compensates a substantial part of its costs.

The study sought to investigate the effect of Multi-choice Goal programming in project Portfolio Analysis, using Lagos State Project Portfolio from between 2017-2021 as a study case. Specifically, the objectives examined the effectiveness of multi-choice goal programming in analyzing the project Portfolio of Lagos State Government and investigated the possible lapses in the use of Multi-choice Goal programming in analyzing the project Portfolio of Lagos State Government. Data were gathered from the State financial Statements and analyzed using Lingo-17 Software. Based on the analysis, the study discovered that the goals formulated can be optimally and minimally attained as the positive deviational and negative deviational variables depict zero. This indicates that the cost incurred on the project portfolio was absolutely minimized during the period and at the same time; Lagos State Government derived the most preferred benefits from it. The study therefore concluded that the State minimized the project costs and at the same time maximized benefits while meeting its overall objectives.

The power sectors in most African countries face an enduring problem of utility performance – electricity utilities have failed to deliver adequate, reliable and competitively priced electricity to support economic growth and improve the welfare of their populations. Despite more than two decades of power sector re-forms, outcomes have been varied and often disappointing. Using a case study de-sign, we explore the five key enduring power challenges. The research utilizes a more powerful analytical framework that combines power sector reform theory and principal-agent theoretical lens to explore the experience of power sector reforms in Kenya and provides a deeper understanding of drivers of utility performance and reform impacts. Empirical findings show that the structural, governance and regulatory reforms that previously created incentives for improved utility performance are increasingly threatened by political influence. Kenya Power’s financial viability has deteriorated in recent years and the regulator has been undermined. One of our major conclusions is that when the relationship between the principal (government) and agent (utility) is well understood and the agent is properly incentivized, performance improvements are possible. However, when the government undermines or muddies those incentives through conflicting political interventions, performance improvements can be reversed.

This paper presents the behavior of decision makers, the possible choices and the strategies 1 resulting from the uncertainties related to the integration of renewable energies. Its uncertainties 2 are the risks associated with the volatility of renewable sources, the dynamics of energy production 3 as well as the planning and operation of the electricity grid. The goal is to model the risk-averse 4 decision-maker’s behavior and the choice of integrating renewable energies into the electrical system. 5 Following a bibliographic approach, we expose a methodology to model the decision-maker’s 6 behavior(risk aversion and predilection for risk) to risk taking. The risk-averse decision maker may 7 adopt nonlinear utility functions. Risk aversion is a behavior that reflects the desire to avoid risk 8 decisions and thus reduces the risk of adverse consequences. A decision support tool is provided to 9 the decision-maker to choose a best-fit strategy based on his preferences. The rational and risk-averse 10 decision-maker would seek to maximize a concave utility function instead of seeking to minimize its 11 cost. Taste or aversion to risk can be modeled by a thematic function of utility.

Utility perceived by individuals is believed to be different from the utility experienced by that individual. System dynamicists implicitly categorize this phenomenon as a form of bounded rationality and traditionally employ a simple smoothing function to capture it. We challenge this generalization by testing it against an alternative formulation of utility perception that is suggested by modern theories of behavioral economics. In particular, the traditional smoothing formulation is compared with the peak-end rule in a simple theoretical model as well as in a medium-size model of electronic health record implementation. Experimentation with the models reveals that the way utility perception is formulated is important and might affect behavior and policy implications of system dynamics models.

When animals evolve sufficient intelligence and dexterity to be able to learn to fabricate utility products (UPs) like tools, the UP's they produce become part of an induced-reproduction system that intrinsically shares many life-like traits with biological organisms, including genome-like fabrication and operation information that is physically-encoded in the animal fabricator’s neural networks. When this set of life- like traits includes a sufficient capacity for system-improving cultural evolution (UP-evolvability), the UPs become ‘para-alive’, i.e., nearly alive, or a form of non-biological UP-paralife that is equivalent to the life- status of biological viruses, plasmids, and transposons. In the companion paper I focus on the evolution of UP-paralife in the context of modern, language-capable humans and its predicted evolution going forward in time (Rice 2022). Here I look backward in time and focus on the origin of UP-paralife and its subsequent coevolution with human intelligence. I begin by determining the pathways leading to the evolution of large brains in the rare lineages of biological life that have sufficient intelligence to learn to fabricate tools –a critical first step in the evolution of UP-paralife. The simplest forms of these learning- based UPs, made by species like chimpanzees and New Caledonian crows, represent only proto-UP- paralife because they lack sufficient UP-evolvability. Expanded UP-evolvability required a combination of three attributes that enabled continuous niche-expansion of the animal fabricator via a new and advanced form of UP-mediated teamwork (TW): i) self-domestication that facilitated TW among low-related individuals, ii) learned volitional words (protolanguage) that represent ephemeral UPs that coordinate TW, and iii) learned fabrication of simple flaked-stone tools with cutting and chopping capabilities (a UP to make other structural UPs) that expanded teammate phenotypes and TW capabilities. This specific triad of attributes is synergistic because each one acts as a TW-enhancer that can gradually erode different components of the three major constraints on TW operation and expansion: too much selfishness, insufficient coordination signals, and insufficient physical traits of teammates. The increase in UP- evolvability was transformative and marked the origin of UP-paralife and the initiation of coevolution between UP-paralife (cultural evolution) and the intelligence of its hominin/human symbiont (genetic evolution) that fostered 2.5 million years of: i) continuous brain size increase and niche-expansion within the genus Homo, and ii) parallel advances in the diversity, complexity and uses of UP-paralife. This coevolution also fostered evolutionary expansion of word-based communication, and eventually language, that acted in a catalyst-like manner to facilitate the evolution of increasingly complex forms of imagination, reasoning, mentalizing, and UP-generating technology. I next focus on the evolution of creativity in the human lineage –in the form of divergent thinking and creative imagination. I conclude that the evolution of this advanced cognitive feature required a preadaptation of sufficient intelligence and is the component of human cognition that was the major causal factor generating the greatly expanded diversity and complexity of UP-paralife currently associated with modern humans. Lastly, I apply my findings to the issue of the prevalence of extraterrestrial intelligent life. I conclude that any exoplanets with detected chemical life will very rarely (e.g., probability ~10-5 for a planet closely matching Earth’s characteristics) have evolved intelligence equalling or exceeding that of humans.

Background/Objectives: The standard of care for acute bacterial skin and skin structure infections (ABSSSIs) requiring intravenous (IV) antibiotics includes vancomycin, administered over several days, in a hospital or outpatient setting resulting in significant costs. Dalbavancin, a long-acting single-dose lipoglycopeptide IV therapy may offer a cost-effective option for adult patients with ABSSSIs in Canada. Methods: A cost-utility analysis (CUA) was performed to evaluate the potential benefits of dalbavancin compared to other IV antibiotics for the treatment of adult patients with ABSSSIs who require IV antibiotics but whose hospitalization, if necessary, is anticipated to be £ 72 hours. Results: This analysis utilized a decision-analytic model showing that dalbavancin was dominant against all IV antibiotic comparators when considering the healthcare system or societal perspective and was associated with lower costs and improved patient adherence. For the sub-population analysis against PWID (people who inject drugs) and the homeless, dalbavancin generated even greater cost savings. Conclusions: We report that dalbavancin when used to treat ABSSSI requiring IV antibiotics may offer cost savings for Canadian healthcare providers through reduced hospitalization time, lower administration and labor costs, minimized risk of healthcare-acquired infections (HAIs), improved patient compliance and optimized resource allocation particularly in patients at risk of non-compliance (First Nations, the homeless and PWID).

Supplier selection/replacement strategies and optimized purchasing policies play a key role in efficient supply chain management in today’s dynamic market. Here we study supplier replacement in a one-level assembly system (OLAS) producing one type of finished product. To assemble the product, we need to provide multi-type components, but assembly will be interrupted if any single component is missing, and incoming units will get hoarded until the missing component arrives. The assembly process can be interrupted by various sources of uncertainty, including delays in component deliveries. There is consequently a non-negligible risk that the assembly process may get stopped any moment. This brings inventory-related costs, which should be minimized. Here we consider discrete lead-time distributions to mimic industry-world reality. We present a model that takes into account not only optimal assignment of component order release dates but also replacement of a critical supplier. For a given unit, we model several alternative suppliers with alternative pricing and lead-time uncertainties, and we evaluate the impact on the total assembly system. For a more general case where several suppliers may be replaced, we propose a genetic algorithm.

Child malnutrition is a critical public health concern that significantly hampers children's physical and mental development and has serious economic repercussions. The World Health Organization (WHO) attributes half of all deaths among children under five to malnutrition, with long-term consequences such as lower educational achievement, decreased productivity, and deepened poverty. The economic impact of child malnutrition extends beyond public health, imposing substantial costs on health systems, households, and the broader economy. This study estimated the burden of child malnutrition in Colombia among children up to four years old using a Markov chain model from a societal perspective. The model simulated six health states, integrating direct and indirect costs, with epidemiological data and international literature guiding the transition probabilities. Surveys were conducted with caregivers to assess indirect costs. Results indicated that malnutrition accounted for 419.84 Disability-Adjusted Life Years (DALYs) per 1,000 inhabitants. The total cost of malnutrition over four years was approximately USD 243.58 million, with an annual average cost of USD 60.89 million, with 65% of the burden falling on households. The findings emphasize the significant economic and health burden of child malnutrition, underscoring the importance of early and comprehensive interventions. Investing in child nutrition can improve health outcomes, reduce economic strain, and enhance productivity, making it a crucial priority in health and economic development agendas.

Aims: The objective of this study was to assess the cost-effectiveness of the CardioMEMS HF system in a HF Clinic in Spain by evaluating the real-time remote monitoring of pulmonary artery pressures, which has shown to reduce heart failure (HF) related hospitalizations and improve the quality of life for selected HF patients. Particularly, the study aimed to determine the value of CardioMEMS in Southern Europe, where healthcare costs are significantly lower and its effectiveness remains uncertain. Methods: This single-centre study enrolled all consecutive HF patients who had been implanted with a pulmonary artery pressure sensor (CardioMEMS-HF system, Abbott Laboratories, Abbott Park, IL, USA). The number of HF hospitalizations in the year before and the year after the sensor implantation was compared and quality-adjusted life years (QALY) gained based on a literature review of previous studies was calculated. Results: The rate of HF hospitalisations was significantly lower at 1 year compared with the year before CardioMEMS implantation (0.25 versus 1.10 events/patient-years, HR 0.22, p=0.001). At the end of first year, the usual management outperformed the CardioMEMS HF system, resulting in a net monetary value difference of 2,540€ per patient and a benefit-cost ratio of 0.38. However, by the end of the second year, the CardioMEMS system is estimated to reduce costs compared to usual management. Conclusions: Based on the results, we suggest that remote monitoring of pulmonary artery pressure with the CardioMEMS HF system represents a long-term cost-effective strategy in a healthcare setting in Southern Europe.

Context: Despite the effort put into developing standards for structuring construction cost, and the strong interest into the field. Most construction companies still perform the process of data gathering and processing manually. That provokes inconsistencies, different criteria when classifying, misclassifications, and the process becomes very time-consuming, particularly on big projects. Additionally, the lack of standardization makes very difficult the cost estimation and comparison tasks. Objective: To create a method to extract and organize construction cost and quantity data into a consistent format and structure, to enable rapid and reliable digital comparison of the content. Method: The approach consists of a two-step method: Firstly, the system implements data mining to review the input document and determine how it is structured based on the position, format, sequence, and content of descriptive and quantitative data. Secondly, the extracted data is processed and classified with a combination of data science and experts’ knowledge to fit a common format. Results: A big variety of information coming from real historical projects has been successfully extracted and processed into a common format with 97.5% of accuracy, using a subset of 5770 assets located on 18 different files, building a solid base for analysis and comparison. Conclusion: A robust and accurate method was developed for extracting hierarchical project cost data to a common machine-readable format to enable rapid and reliable comparison and benchmarking.

The article proposes a mathematical model for creating playlists based on the emotional utility of the consumer, aiming to maintain high user interest in music streaming platforms (Lugos Abarca, 2024). The proposed method follows these steps: first, it calculates the MEEPE of Songs on the digital platform; subsequently, it quantitatively defines the Consumer's MEEPI before exposure to music; then, it operates the MEEPE of the Songs with the consumer's initial MEEPI using the known resolution process (Lugos Abarca, 2023); finally, it employs an emotional utility function to determine possible levels of emotional satisfaction and establish the playback order. This results in the creation of an efficient theoretical model. It is recommended to expand the computational study of the model in future research by using a broader set of songs and considering various initial MEEPI of the consumer. The article's originality lies in its ability to predict, quantitatively and theoretically, the level of satisfaction a music consumer could experience when listening to a playlist.

The objective of this research is to propose a utility function that calculates the possible level of satisfaction that a music consumer would achieve after listening to a song according to the emotional response obtained from a song. Assuming that the consumer's musical preferences are satisfied if the predominant emotions of his current emotional state increase; the probabilistic emotional-musical model (Lugos Abarca, 2023) is used to construct such a utility function. By posing a hypothetical scenario, realistic results were obtained, which guarantee, in principle, its use in theoretical practice. The originality of this research lies in proposing a mathematical tool to study, quantitatively, the decision making of a musical consumer influenced by his emotions. The main conclusion being its importance in the music industry, since the function could predict, theoretically, whether a song will be accepted or rejected by the consumer in comparison with the competition.

Existing literature on the relationship between ride-hailing (RH) and transit services is limited to empirical studies that lack real-time spatial contexts. To fill this gap, we took a novel real-time geospatial analysis approach. With source data on ride-hailing trips in Chicago, Illinois, we computed real-time transit-equivalent trips for all 7,949,902 ride-hailing trips in June 2019; the sheer size of our sample is incomparable to the samples studied in existing literature. An existing Multinomial Nested Logit Model was used to determine the probability of a ride-hailer selecting a transit alternative to serve the specific O-D pair, P(Transit|CTA)[1]. We find that 31% of ride-hailing trips are replaceable, whereas 61% of trips are not replaceable. The remaining 8% lie within a buffer zone. We measured the robustness of this probability using a parametric sensitivity analysis and performed a two-tailed t-test. Our results indicate that of the four sensitivity parameters, the probability was most sensitive to the total travel time of a transit trip. The main contribution of our research is our thorough approach and fine-tuned series of real-time spatiotemporal analyses that investigate the replaceability of ride-hailing trips for public transit. The results and discussion intend to provide perspective derived from real trips and we anticipate that this paper will demonstrate the research benefits associated with the recording and release of ride-hailing data. [1] This value defines the replaceability of the trip, where a value ranging from 0 to 0.45 is considered not-replaceable (NR), and a value ranging from 0.55 to 1.0 is considered replaceable (R).

River valley bottoms have hydrological, geomorphological, and ecological importance and are buffers for protecting the river from upland nutrient loading coming from agriculture and other sources. They are relatively flat, low-lying areas of the terrain that are adjacent to the river and bound by increasing slopes at the transition to the uplands. These areas have under natural conditions, a groundwater table close to the soil surface. The objective of this paper is to present a stepwise GIS approach for the delineation of river valley bottom within drainage basins and use it to perform a national delineation. We developed a tool that applies a concept called cost distance accumulation with spatial data inputs consisting a river network and slope derived from a digital elevation model. We then used wetlands adjacent to rivers as a guide finding the river valley bottom boundary from the cost distance accumulation. We present results from our tool for the whole country of Denmark carrying out a validation within three selected areas. The results reveal that the tool visually performs well and delineates both confined and unconfined river valleys within the same drainage basin. We use the most common forms of wetlands (meadow and marsh) in Denmark's river valleys known as Groundwater Dependent Ecosystems (GDE) to validate our river valley bottom delineated areas. Our delineation picks about half to two-thirds of these GDE. However, we expected this since farmers have reclaimed Denmark's low-lying areas during the last 200 years before the first map of GDE was created. Our tool can be used as a management tool, since it can delineate an area that has been the focus of management actions to protect waterways from upland nutrient pollution.

New vaccination programs need a method to measure success based on pre-defined outcomes evaluated over pre-specified time frames. Reimbursement of newly approved vaccines is often reliant on simulated projections that approximate real-world scenarios, due to limited long-term data availability. Adjustments to reimbursement prices are infrequent, barring instances of market competition-induced price erosion through tender processes. Consequently, comprehensive monitoring of the vaccine effect (VE) for an adequate duration to evaluate the success of vaccination programs remains rare. Such data are essential to inform expectations of vaccine effect and the timeline for measurable success of the investment. An example is provided here by the 15-year assessment of the rotavirus vaccination program in Belgium (RotaBIS study spanning 2005 to 2019 across 11 hospitals). The vaccination program started in late 2006 and yielded sub-optimal outcomes. Long-term VE surveillance data provided insights into infection dynamics, disease progression, and vaccine performance. The presented analysis introduces novel conceptual frameworks and methodologies. Cost-effectiveness analysis (CEA) evaluates the initial target vaccination population, considering the effectiveness of direct and indirect effects of the vaccine, compared with a historical group that is unvaccinated. Cost-impact analysis (CIA) covers a longer period and considers the whole vaccinated and unvaccinated population in which the vaccine has direct and indirect effects. The success index ratio of CIA over CEA outcomes evaluates the vaccination performance. Good performance has ≤ 1 index value combined with a low CEA. This measure is therefore a valuable aid for new vaccine introductions. It supports the establishment of robust monitoring protocols.

This article summarizes Chinese framework for regulating artificial intelligence and integrates evolutionary game theory with cost-benefit analysis to establish a model and simulation. This framework is employed to analyze the behavioral trends among three distinct entities: governmental bodies, third-party independent institutions, and AI companies within the context of regulatory relationship. The findings indicate that: (1) The cost-benefit dynamics within the regulatory legal nexus significantly influence the behaviors of these entities; (2) Under the condition of normalized government regulation approaching full enforcement, the behavioral choices of third-party independent institutions and AI companies exhibit cyclical fluctuations.The paper draws two principal conclusions: (1) The regulatory framework need to be tailored to the specific risks presented by AI and the relative costs and benefits of legal enforcement in different jurisdictions. (2) From a cost-benefit standpoint, government intervention in AI regulation ought to be circumscribed, with government regulation focusing on critical legal risks. Other aspects of regulatory control should be delegated to cooperative legal framework that allows the participation of the independent third-party institution,which brings a nuanced and specialized approach to the governance of AI.

Background & Objective: Acne Vulgaris is a common skin disease, with 5 % prevalence in Pakistan and has a significant physiological, psychological, emotional and social impact on the population, our study aims to estimate its annual economic burden per person in Pakistan.Methodology: Economic burden was estimated by using Cost of Illness analysis. All types of costs, including direct medication costs, direct non-medical costs and indirect costs due to loss of work. Data were collected from online databases and literature reviews. Results: Cost of illness analysis estimated that the cost of Acne Vulgaris treatment varies for mild, Moderate and severe acne. Acne is causing an annual economic burden of PKR 1,92,366 PKR per person (direct cost is PKR 1,86,366 and indirect cost 6,000) for an expensive treatment and PKR 53,550 (direct cost is PKR 47550 and indirect cost 6,000) for a cheap treatment. Limitation: Being an LMIC, Pakistan needs extensive study on the pharmacoeconomic analysis of Acne for proper and rational allocation of resources. Conclusion: Acne has a significant economic burden in Pakistan. Even with significant impact of Acne, there is very minute work done about Acne in Pakistan.

Time overrun and tight deadlines set by the client are the critical challenges faced by the construction industry for decades. The fast-track technique was introduced to overcome these challenges. Since its introduction in 1970s, a number of construction projects have been completed on fast-track however the stakeholders still lack confidence in its implementation, mainly due to the lack of awareness of the impact that variances in cost and quality have on project duration on fast-track schedule and the lack of decision support available in this domain. This research aims at analysing the impact of cost and quality variances on project duration thereby proposing a decision support model that facilitates the decision-making process. Data was gathered from 159 construction industry professionals on a 5-point Likert scale based questionnaire. Structural equation modelling (SEM) software was used to analyse the data. 4 hypotheses were developed including the mediation analysis. The results of the analysis showed that both cost and quality variances have significant impact on variances in project duration. Moreover, the quality variance also significantly impacts the variations in project budget. The mediation analysis showed that cost variance mediates a statistically significant impact between variations in project quality and project duration. The R2 values of the proposed model indicated that 78.4% of the changes in project duration are attributed to changes in project cost and quality whereas 72.9% variations in project cost are attributed to changes in project quality. The IPMA results showed that the decisions resulting in variations in project cost have the greatest potential to enhance project performance in terms of project duration among which adopting scope freeze approach at early design stage, over-designing the facility and early procurement of long-lead-time items are the most influential decisions whereas over-extending the resources on quality related decisions may result in adverse effects on project duration which include early involvement of O&M team in design phase, early involvement of the contractor in design phase, 90% acceptable quality compromise and quality management plan submission in pre-design stage. Q2, RMSE, MAE and CVPAT values confirm that the proposed model has high out-of-sample predictability.

Agarwood, a highly valuable fragrant wood of Aquilaria spp. has been widely used in perfumes, traditional medicine, religious rites and cultural activities. Due to the presence of aromatic and medicinal properties, the Agarwood has gained its economic importance in recent years. It has been providing livelihood and employment facilities to many people who are cultivating those. Owing to high demand and profitability, the people of Assam has started to cultivate Agarwood in a commercial manner in recent days. This study was conducted to examine the economic viability of Agarwood cultivation in Assam and to understand the problems of the cultivators to consider Agarwood cultivation as the primary source of income. The primary data were collected during the months of May and June, 2022 from 210 households using structured questionnaire. The cost-benefit analysis revealed that INR 100 of initial investment yields a net benefit of INR 623 which indicates that the return from the Agarwood cultivation among the cultivators are very high. Thus, the present study argues that the government should encourage the cultivators by providing the necessary support in the form of a legalized market, credit requirement, creating the awareness about the demand of Agarwood and making provision of training.

This study uses machine learning to identify key factors influencing the cost-effectiveness of over-the-counter (OTC) medications. By developing a novel cost-effectiveness rating (CER) from user ratings and prices, we analyzed data from Amazon. The findings indicate that FSA/HSA eligibility, symptom treatment range, safety warnings, special effects, active ingredients, and packaging size significantly impact cost-effectiveness across cold, allergy, digestion, and pain relief medications. Medications eligible for FSA or HSA funds, treating a broader range of symptoms, and having smaller packaging are perceived as more cost-effective. Cold medicines with safety warnings were found to be cost-effective due to their lower average price and effective ingredients like phenylephrine and acetaminophen. Allergy medications with kid-friendly features showed higher cost-effectiveness, and ingredients like calcium, famotidine, and magnesium boosted the cost-effectiveness of digestion medicines. These insights help consumers make informed purchasing decisions and assist manufacturers and retailers in enhancing product competitiveness. Overall, this research supports better decision-making in the pharmaceutical industry by highlighting factors that drive cost-effective medication purchases.

In order to evaluate the economy of superhighway, on the basis of the analysis of the cost of the ordinary expressway and high speed railway, the cost of superhighway is estimated. On this basis, the standard of the toll of superhighway at all levels is determined by reference to the standard of the construction cost and the toll collection standard of the ordinary expressway. According to the toll collection standard of superhighway and the fuel consumption cost of superhighway at all levels, the cost of single car and the single person cost of superhighway are calculated. Based on the analysis of highway passenger transport, railway passenger transport and civil aviation ticket price, the single person cost per kilometer of the above travel modes is calculated and compared with the single person travel cost per kilometer of superhighway. The results show that the single person cost of superhighway is between 0.29 and 0.47 yuan /km, which is 0.28 yuan /km higher than the highway bus, 0.18 yuan /km higher than the ordinary expressway self driving and 0.23 yuan /km higher than the express train, but 0.78 yuan/km lower than that of the first class seat of high-speed train, and is 0.92 yuan/km far lower than that of civil aviation flight economy class and 2.42 yuan/km lower than the business class. Therefore, the superhighway trip has certain advantages in economy.

Background: Barrett’s Esophagus (BE) is the only known precursor for esophageal adenocarcinoma (EAC). Patients with multiple risk factors for BE/EAC are recommended for screening, however few eligible patients undergo evaluation by endoscopy. EsoGuard® (EG) is a commercially available biomarker assay used to analyze esophageal cells collected non-endoscopically with EsoCheck® (EC), for qualitative detection of BE/EAC. This study evaluates real-world clinical utility of EG on cells collected with EC in patients defined by U.S. gastroenterology societies to be at-risk for BE and EAC. Methods: This multi-center, observational CLinical Utility of EsoGuard (CLUE) study enrolled screening-eligible patients as defined by the American College of Gastroenterology (ACG) and the American Gastroenterological Association (AGA). Clinical utility was evaluated by the provider decision impact of EG, and additionally by assessing patient compliance outcomes with recommended follow-up testing. Results: 551 patients were enrolled, with a mean age of 62.0 ± 12.4 years and 56.1% (309/551) meeting ACG guideline criteria for BE screening. EC cell collection was successful in 97.1% (535/551), among which EG positivity rate was 27.3% (n = 146). The provider decision impact was high with 100% of EG positive patients being referred for esophagogastroduodenoscopy (EGD), while 98% of EG negative patients were not referred. Among EG positive patients, the overall compliance with follow-up EGD was 85.4%. Conclusions: Combining EC non-endoscopic esophageal cell collection with the EG biomarker assay is effective in guiding provider decision-making for detection of BE and EAC. Patients with positive EG results demonstrate high compliance with recommended follow-up EGD.

The rise of digital technology and artificial intelligence has led to a significant change in the way financial services are delivered. One such development is the emergence of robo-advising, which is an automated investment advisory service that utilizes algorithms to provide investment advice and portfolio management to investors. Robo-Advisors collect information about their clients’ preferences, financial situation and future goals through questionnaires, then recommend ETF based portfolios supposed to fit investor’s risk profile. However, questionnaires seem to be vague, and robos do not reveal the methods used for investor profiling or asset allocation. This study aims at contributing by proposing an investor profiling method, based only on the level of relative risk aversion (RRA) of investors. We show how to determine RRA optimal portfolios and compare the performance of our portfolios with portfolios proposed by the Riskalyze platform.

In this paper, we propose and evaluate two mechanisms aimed at improving the communication reliability of IEEE 802.15g SUN (Smart Utility Networks) in industrial scenarios: RTS (Re-Transmission Shaping), which uses acknowledgements to track channel conditions and dynamically adapt the number of re-transmissions per packet, and AMS (Adaptive Modulation Selection), which makes use of reinforcement learning based on MAB (Multi-Armed Bandits) to choose the modulation that provides the best reliability for each packet re-transmission. The evaluation of both mechanisms is performed through computer simulations using a dataset obtained from a real-world deployment and two widely used metrics, the PDR (Packet Delivery Ratio) and the RNP (Required Number of Packet transmissions). The PDR measures the ratio between received and transmitted packets, whereas the RNP is the number of packet repetitions before a successful transmission. The results show that both mechanisms allow to increase the communication reliability while not jeopardizing the battery life-time constraints of end devices. For example, when three re-transmissions per packet are allowed, the PDR reaches 98/96\% with a RNP of 2.03/1.32 using RTS and AMS, respectively. Additionally, the combination of both proposed mechanisms allows to reach a 99% PDR with a RNP of 1.7, making IEEE 802.15.4g SUN compliant with the stringent data delivery requirements of industrial applications.

Packet re-transmissions are a common technique to improve link reliability in low-power wireless networks. However, since packet re-transmissions increase the end-device energy consumption and the network load, a maximum number of re-transmissions per packet is typically set, also considering the duty-cycle limitations imposed by radio-frequency regulations. Moreover, the number of re-transmissions per packet is typically set to a constant value, meaning that all packet re-transmissions are treated the same regardless of actual channel conditions (i.e., multi-path propagation or internal/external interference effects). Taking that into account, in this paper we propose and evaluate the concept of re-transmission shaping, a mechanism that manages packet re-transmissions to maximize link reliability, while minimizing energy consumption and meeting radio-frequency regulation constraints. The proposed re-transmission shaping mechanism operates by keeping track of unused packet re-transmissions and allocating additional retransmission when the instantaneous link quality decreases due to channel impairments. To evaluate the re-transmission shaping mechanism we use trace-based simulations using a IEEE 802.15.4g SUN data-set and two widely used metrics, the PDR (Packet Delivery Ratio) and the RNP (Required Number of Packets). The obtained results show that re-transmission shaping is a useful mechanism to improve link reliability of low-power wireless communications, as it can increase PDR from 77.9% to 99.2% while sustaining a RNP of 2.35 re-transmissions per packet, when compared to using a single re-transmission per packet.

This paper formulates a new strategy for participatory forest management consisting of encouraging public participation as long as it increases empathy among participants. The strategy requires the homogeneous representation of the opinion of a participant (i.e. to determine how they assess a forest plan and identify the best one). Utility assessments are prepared for participants through pair-comparisons between meaningful points in the territory and from value functions based on forest indicators. The best plan is designed by applying combinatorial optimization algorithms to the utility of a participant. The calculating of empathy -of one participant relative to another - is based on the equivalence of their respective utilities when the current forest plan is modified. This involves calculating the opinions that are due to systematic changes in the collective plan for those participants that each participant supposes will affect the utility of the other participants. Calculating empathy also requires knowing the interactions among participants, which have been incorporated through agent-based simulation models. Application of the above methodology has confirmed the association between increases in empathy and convergence of opinions in different scenarios: well and medium-informed participants and with and without interaction among them, which verifies the proposed strategy. In addition, this strategy is easily integrated into available information systems and its outcomes show advantages over current participatory applications.

Due to an urgent need for reducing the fast progressing climate changes, a rapid, standardized and replicable solution for the infrastructure restructuring of heat demand coverage of buildings at district and city level must be developed. As more and more communities in Europe, especially in Germany, are obligated to have plans for coverage of heat demand, city planners, energy agencies seek a tool, which will help them to design the first drafts of heating network routes, which can supply whole districts and cities with renewable energy. ArcGIS Pro Tools like Least-Cost-Path-Analysis (LCPA) and Closest Facility (CF) allow to find the shortest and “cheapest” way between the heat source and heat consumers in the analyzed areas. Starting from the community level, through the district, county, voivodeship and whole country levels, the replication of the methods for generating district heating (DH) network infrastructure can be achieved. The proposed LCPA and CF based methods help to design the most suitable and efficient DH networks in the analyzed areas. As only few open-source data input, like street networks and building footprints are needed, the methods can be implemented in all communities of the country of Poland. In this paper one example of one community of Wroclaw county, called Siechnice and surroundings is presented.

A mechanical ventilation system is a big support for breathing complications, in which an external solution is quite necessary to keep oxygen compensation in the patients. Its knowledge is well widespread and different equipment has been developed. However, they are very expensive and their quantity in medical centers is not sufficient, especially in Peru. Hence, it has been required to develop new methods to provide oxygen by a low cost equipment; Protofy, a research group from Spain, designed one of the first low cost mechanical ventilation systems which was medically validated by its government. In this sense, a redesign of the mechanical ventilation system was carried out according to the local requirements and available technology, a different airbag resuscitator with different properties and geometry, but maintaining its working concept based on a cam compression mechanism. Sensors and a display were added to improve the performance with a control algorithm for the rotation frequency and to show the ventilation curves over time to the medical staff. It was necessary to develop a mathematical model to relate the behavior between ventilation curves for a patient and physical variables of the design, especially in the epidemic COVID 19, that many countries are dealing with at the time research is being conducted. The mechanical ventilation system was redesigned, fabricated, and tested measuring its ventilation curves over time. Results indicate that this redesign provides a sturdy equipment able to work during a longer lifetime than the original. The replicability of the ventilation curves behavior is assured, while the mechanism dimensions are adapted for a particular airbag resuscitator. The mathematical model of the whole system can predict satisfactorily the ventilation curves over time and was used to provide the air pressure, volume, and flow as a function of the rotation angle measured by sensors.

The aim of this study was to measure one-year total cost of stroke and to investigate the value of stroke care, defined as cost per QALY. The study population included 892 patients with first ever acute stroke, hemorrhagic and ischemic, (ICD-10 codes: I61, I63 and I64) admitted within 48 hours of symptoms onset to nine public hospitals located in six cities. We conducted a bottom-up cost analysis from the societal point of view. All cost components including direct medical costs, productivity losses due to morbidity and mortality and informal care costs were considered. We used an annual time horizon, including all costs for 2021 irrespective of the time of disease onset. The average cost (direct and indirect) was extrapolated in order to estimate the national annual burden associated with stroke. We estimated the total cost of stroke in Greece at €343.1 mil a year in 2021, (€10,722/patient or €23,308 per QALY). Out of €343.1 mil., 53.3% (€182.9 mil) consisted direct healthcare cost representing 1.1% of current health expenditure in 2021. Overall, productivity losses were calculated at €160.2 mil. The mean productivity losses were estimated to 116 work days with 55.1 days lost due to premature retirement and absenteeism from work, 18.5 days lost due to mortality and 42.4 days lost due to informal caregiving by family members.This study highlights the burden of stroke and underlines the need for stakeholders and policy makers to re-organize stroke care and promote interventions that have been proved as cost-effective

For the majority of the contractual arrangements used in construction projects, the owner is not responsible for the cost deviations due to the variability of labor productivity or material price, amongst many other aspects. Consequently, the cost performance of a project may be entirely distinct for the owner and the contractor. Since the majority of the quantitative research on cost estimation and deviation found in the literature adopts the owners’ perspective, this research provides a contribution towards modelling costs and cost deviation from a contractors’ perspective. From an initial sample of 13 residential building and 10 office building projects, it was possible to develop models for cost estimation at the early stage of development including both endogenous and exogenous variables. Although the sample is relatively small, the authors were able to fully analyze all the cost data, using no secondary sources of data (very frequent in cost modelling studies). The statistically significant variables in the cost estimation models were the areas above and below ground and the years following the 2008 financial crisis, including the international bailout (2011-2014) period. For estimating the unit cost, a nonlinear model was obtained with the number of underground and total floor, the floor ratio and the years following the 2008 financial crisis, including the international bailout (2011-2014) period as predictors. For the office buildings, it was also found a statistically significant correlation between the cost deviation and the number of underground floors.

Installations of decentralised Renewable Energy Systems (RES) are becoming increasing popular as governments introduce ambitious energy policies to curb emissions and slow surging energy costs. This work presents a novel model for optimal sizing for decentralised renewable generation and hybrid storage system to create a Renewable Energy Community (REC), developed in Python. The model implements PV Solar and Wind Turbines combined with a hybrid battery and Regenerative Hydrogen Fuel Cell (RHFC). The electrical service demand is derived using real usage data from a rural island case study location. Cost remuneration is managed with an REC virtual trading layer, ensuring fair distribution among actors in accordance with the European RED(III) policy. A multi-objective Genetic Algorithm (GA) stochastically determines the system capacities such that the inherent trade-off relationship between project cost and decarbonisation can be observed. The optimal design results in an LCOE of 0.15€/kWh, reducing costs by over 50% compared with typical EU grid power, with a project IRR of 10.8%, simple return of 9.6%/year, and ROI of 9 years. Emissions output from grid only use is reduced by 72% to 69 gCO2e/kWh. Further research of lifetime economics and additional revenue streams in combination with this work could provide a useful tool for users to quickly design and prototype future decentralised REC systems.

Recent technological improvements have made abundant changes in construction industry. In specific, some technical applications, such as Building Information Modeling (BIM) opens up many possibilities. Some studies have articulated the use of BIM and its advantages in construction, but most of them are theoretical, not practical. This study is to provide an insight to such obstacles in BIM research. By investigating a real project that could utilize BIM in planning and construction phases, the authors try to investigate a possible outline of advantages in BIM implementation. The study area was set to a railway construction site in South Korea. The site covers a multiple railway tracks, stations, telecommunication facilities, infrastructure facilities, railway structures, and so numerous. In the site, the authors have identified 12 errors in 7 projects that could be prevented if BIM was utilized before the construction. The total upfront costs required to provide a BIM for 7 projects were $116,348. On the other hand, the total costs required to fix the errors in 7 projects were $166,486. This can be regarded as the benefits of using BIM because if BIM was implemented then the associated errors are easily replaced. Therefore, the benefit-cost ratio can be estimated as 1.32 for one-month delay and 1.36 for a three-month delay.

Quality of Service (QoS) metrics deal with network quantities, e.g. latency and loss, whereas Quality of Experience (QoE) provides a proxy metric for end-user experience. Many papers in the literature have proposed mappings between various QoS metrics and QoE. This paper goes further in providing analysis for QoE versus bandwidth cost. We measure QoE using the widely accepted Mean Opinion Score (MOS) rating. Our results naturally show that increasing bandwidth increases MOS. However, we extend this understanding by providing analysis for internet access scenarios, using TCP, and varying the number of TCP sources multiplexed together. For these target scenarios our analysis indicates what MOS increase you get by further expenditure on bandwidth. We anticipate that this will be of considerable value to commercial organizations responsible for bandwidth purchase and allocation.

Background: Telemedicine (interconsultation between primary and hospital care teams) has been operating in the counties of Central Catalonia Bages, Moianès and Berguedà since 2011 in the specialties of teledermatology, teleulcers, teleeyelids and teleaudiometries. For the period until the end of 2019, a total of 52,198 visits have been recorded. Objective: To analyse the differential costs between telemedicine and usual care in a semi-urban environment. Methodology: A cost-minimization evaluation, including direct and indirect costs from a societal perspective, distinguishing healthcare and user’s costs, within a three-month period. Results: Telemedicine saved € 780,397 over the period analysed. A differential cost favourable to telemedicine of about € 15/visit has been observed, the patient being the largest beneficiary of this saving (by 85%) in terms of shorter waiting times and travel costs. From the healthcare system perspective, moving the time spent in a hospital care consultation to primary care is efficient in terms of the total time devoted per patient. In social terms and in this context, telemedicine is more efficient than usual care. Conclusion: Users’ saving of time in terms of consultation and travel is the main driver of interconsultation between primary and hospital care savings in a semi-urban context. The telemedicine service is also economically favourable for the healthcare system, enabling it to provide a more agile service, which also benefits the healthcare professionals.

Chipman contends, in stark contrast to the conventional view, that utility is not a real number but a vector and is inherently lexicographic in nature. According to these views, it will be proved that, for every preordered topological space (X,≾,t), the assumption t to be finer than the order topology t≾ on (X,t), i.e. t⊇t≾, and the assumption the quotient topology t∣∼≾ that is defined on the preordered set (X∣∼,≾∣∼) of indifference classes of ≾ to be Hausdorff imply that a cardinal number κ and a (complete) preorder ≲ on {0,1}κ that is coarser than the lexicographical ordering ≤lex on {0,1}κ, i.e. ≤lex⊂≲, can be chosen in such a way that there exists a continuous order-embedding ϑ:(X,≾,t)⟶({0,1}κ,≲,t≤lex). This theorem will be compared with a theorem that, in particular, describes necessary and sufficient conditions for ≾ to have a continuous multi-utility representation.

Genome-based testing in oncology is a rapidly expanding area of health care which is the basis of the emerging area of precision medicine. Efficient and considered adoption of novel genomic medicine testing is hampered in Canada by the fragmented nature of health care oversight as well as by lack of clear and transparent processes to support rapid evaluation, assessment and implementation of genomic tests. This article provides an overview of some key barriers and proposes approaches to addressing these challenges as a potential pathway to developing a national approach to genomic medicine in oncology.

Abstract: Background: Trauma is the leading cause of morbidity and mortality in young patients, acute surgical conditions cause morbidity and mortality in patients of all ages. Computed tomography scan (CT) assist greatly in the investigation and management of these patients with blunt and penetrating trauma, facilitating early diagnosis and expedites early appropriate treatment of these patients. Acute non-traumatic surgical conditions also mimic non-surgical pathologies and differentiating the two is important because management is different and any delay in surgical intervention results in high morbidity and some may even result in mortality. Method: Literature review of the role of multidetector CT scan (MDCT) in managing acute surgical emergencies and trauma-diagnosis in the trauma patient and patients presenting with acute surgical emergencies. The focus is on the role of the MDCT in the management of these patients. Results highlight that the use of MDCT expedites management of these patients, allowing early surgical intervention and preventing unnecessary surgical interventions where the intervention is not indicated, based on the MDCT results. Conclusion: This paper emphasizes the important role that is played by the MDCT in the management of the above patients.

A stochastic dominance (SD) relation can be defined by two different perspectives: One from the view of distributions, and the other one from the view of expected utilities. In early days, Fishburn investigated SD from the view of distributions and we refer this perspective as Fishburn’s SD. One of his many results was the development of fractional-order SD for continuous distributions. However, discrete fractional-order SD may not be generalized directly since some properties of fractional calculus do not have a discrete counterpart. In this paper, we develop a discrete analogue of fractional-order SD from the view of distributions. We generalize the order of SD by Lizama’s fractional delta operator, show the preservation of SD hierarchy, and formulate the utility classes that are congruent with our SD relations. This work brings a message that some results of discrete SD cannot be generalized directly from continuous SD. We characterize the difference between discrete and continuous fractional-order SD, as well as the way to handle them.

The physical and economic sustainability of using Built Environment Wind Turbine (BEWT) systems depends on the wind resource potential of the candidate site. Therefore, it is crucial to carry out a wind resource assessment prior to deployment of the BEWT. The assessment results can be used as a referral tool for predicting the performance and lifespan of the BEWT in the given built environment. To date, there is limited research output on BEWTs in South Africa with available literature showing a bias towards utility-scale or conventional ground based wind energy systems. This study aimed to assess wind power generation potential of BEWT systems in Fort Beaufort using the Weibull distribution function. The results show that Fort Beaufort wind patterns can be classified as fairly good and that BEWTs can best be deployed at 15m for a fairer power output as roof height wind speeds require BEWT of very low cut-in speed of at most1.2ms⁻¹.

This paper presents a theoretical evaluation of the prices of mixed briquettes produced from co-conut shells (CCS), banana peels (BNP), rattan waste (RWT), and sugarcane bagasse (SGC), and, on the other hand, an analysis of the economic viability of their use as a replacement for conventional household fuels (Liquefied Petroleum Gas, fuelwood, and wood charcoal) in house-holds in Cameroon. The investigation was carried out using the Life Cycle Cost method on a typical household over a ten-year period with annual cooking energy requirements of 950 kWhth. The SGC-CCS and SGC-RWT mixed briquettes with a ratio higher than 7.75% and 11.1%, respectively, have prices lower than 0.063 €/kWhth. The Present Value of the Net Benefit is posi-tive for the use of SGC-CCS and SGC-RWT mixed briquettes. The results show that by making the right mixes of residues, it is possible to obtain biomass briquettes that are less expensive than conventional fuels.

We analyze a time-delayed SIQR model that considers the transportation-related infections and entry-exit screening. This model aims to determine the measures for preventing and controlling major emergent infectious diseases and the associated costs. We calculate the basic reproduction number (R0), apply the linearization method, and construct an appropriate Lyapunov function to determine the stability of the disease-free equilibrium in the local and global. We collect COVID-19 infection data from two regions in the United States in 2020 for data fitting, obtain a set of optimal parameter values, and show that the model is suitable for simulating the outbreak and spread of emerging infectious diseases. We find that transportation-related infections increase the basic reproduction number, enhancing the impact on disease spread. Entry-exit screening effectively suppress the spread of disease by reducing the basic reproduction number. Furthermore, we investigate the influence of the incubation period on disease and find that a shorter incubation period results in a shorter duration but a larger scale of infection, and the peaks are reduced. We conduct a sensitivity analysis of the R0 and propose three measures to prevent the spread of new infectious diseases based on the most sensitive parameters: wearing masks, implementing urban closures, and administering medication to sick but not yet hospitalized patients promptly. In the case of COVID-19, we use Pontryagin’s minimum principle to get time-varying control measures to control the spread of the outbreak. Optimal control effectively controls the development and deterioration of the disease. Finally, several control measures are compared through cost-effectiveness analysis, and the results show that wearing masks is the most cost-effective measure. Our study provides some practical guidance for controlling the spread of major emerging infectious diseases.

Additive Manufacturing (AM), also know as 3D Printing (3DP), is a widely used layer-by-layer manufacturing process, it is evolving rapidly both in research and industry. Among all AM methods, Material Extrusion (ME) is one of the most popular techniques. Based on ME, another new AM method is developed, which is Low-cost Metal Material Extrusion (LCMME). In this newly developed process, pure metallic parts could be fabricated after sintering the metal infused additively manufactured parts. Both AM and sintering process parameters will have influence on the quality of the final pure metallic parts. In this research, several statistics methods were used to analyze the data gotten from the experiment. Then two Machine Learning (ML) algorithms were used to predict the Surface Roughness (SR) of the final specimens. Additionally, the results show that the neural network (NN) is more accurate than the support vector regression (SVR) on prediction.

This study introduces a novel method for optimising the size and control strategy of grid-connected, utility-scale photovoltaic (PV) systems with battery storage aimed at energy arbitrage and frequency containment reserve (FCR) services. By applying genetic algorithms (GA), the optimal configurations of PV generators, inverters/chargers, and batteries are determined, focusing on maximising the net present value (NPV). Both DC- and AC-coupled systems are explored. The performance of each configuration is simulated over a 25-year lifespan, considering varying pricing, solar resources, battery ageing, and PV degradation. Constraints include investment costs, capacity factors, and land use. A case study conducted in Wiesenthal, Germany, is followed by sensitivity analyses, revealing that a 75% reduction in battery costs is needed to make AC-coupled PV-plus-battery systems as profitable as PV-only systems. Further analysis shows that changes in electricity and FCR pricing, as well as limits on FCR charging, can significantly impact NPV. The study confirms that integrating arbitrage and FCR services can optimize system profitability.

The IEEE 802.15.4-2015 standard includes the SUN (Smart Utility Networks) modulations, i.e., SUN-FSK, SUN-OQPSK and SUN-OFDM, which provide long range communications and allow to trade data rate, occupied bandwidth and reliability. However, given the constraints of low-power devices and the challenges of the wireless channel, communication reliability cannot still meet the PDR (Packet Delivery Ratio) requirements of industrial applications, i.e., PDR>99%. Hence, in this paper we evaluate the benefits of improving communication reliability by combining packet transmissions with modulation diversity using multiple IEEE 802.15.4g SUN modulations. The results derived from a real-world deployment show that going from 1 to 3 packet transmissions with the same SUN modulation can increase PDR from 85.0/84.6/71.3% to 94.2/94.1/86.0% using SUN-FSK, SUN-OQPSK and SUN-OFDM, respectively. Combining the same number of packet transmissions with modulation diversity allows to further increase the average PDR to 97.1%, indicating its potential as a tool to help meeting the reliability requirements of industrial applications.

Retail buildings can provide energy flexibility to the grid with the possibility of load shifting and building automation systems. Demand response is a collective innovation in the smart grid domain. Various stakeholders should be involved in the demand response activities to ensure the success. The owners or senior management of retail buildings need to consider the stakeholders who are directly influenced by the demand response participation, e.g. customers and employees. Meanwhile, demand response activities are influenced by various factors, such as energy market structure, policy, etc. Therefore, this paper investigates the demand response readiness for retail buildings with three aspects: energy control preferences, stakeholder engagement, and cross-national differences. A questionnaire is designed and collected with store managers in Denmark (N=51) and the Philippines (N=36). The result shows that: 1) retail stores are much readier to participate in the implicit demand response by manual energy control compared to the utility control or building automation. Meanwhile, store managers have significant concerns about business activities and indoor lighting compared to other aspects; 2) the statistically significant influential factors for retail stores to participate in the demand response are related to whether the DR participation matches the company goals, influences business operation, and whether retail stores are lack of related knowledge; 3) retail stores believe that stakeholders should be informed about the DR activities but not involved in; 4) there are significant differences regarding the energy control preferences and concerns between retail stores in Denmark and the Philippines, but no significant difference regarding the stakeholder engagement.

Purpose: Expanded carrier screening (ECS) informs couples of their risk of having offspring affected by certain genetic conditions. Limited data exists assessing the actions and reproductive outcomes of at-risk couples (ARCs). We describe the impact of ECS on planned and actual pregnancy management in the largest sample of ARCs studied to date. Methods: Couples who elected ECS and were found to be at high risk of having a pregnancy affected by at least one of 176 genetic conditions were invited to complete a survey about their actions and pregnancy management. Results: Three hundred ninety-one ARCs completed the survey. Among those screened before becoming pregnant, 77% planned or pursued actions to avoid having affected offspring. Among those screened during pregnancy, 37% elected prenatal diagnostic testing (PNDx) for that pregnancy. In subsequent pregnancies that occurred in both the preconception and prenatal screening groups, PNDx was pursued in 29%. The decision to decline PNDx was most frequently based on the fear of procedure-related miscarriage, as well as the belief that termination would not be pursued in the event of a positive diagnosis. Conclusions: ECS results impacted couples’ reproductive decision-making and led to altered pregnancy management that effectively eliminates the risk of having affected offspring.

The impulse of the Fourth Industrial Revolution is triggering the demand for few specific metals. These include copper, silver, gold, and platinum group metals (PGMs), with important applications in renewable energies, green hydrogen, and electronic products. However, the continuous extraction of these metals is leading to a rapid decline in their ore grades and, consequently, increasing the environmental impact of extraction. Hence, obtaining metals from secondary sources, such as waste electrical and electronic equipment (WEEE), becomes imperative for both environmental sustainability and ensuring availability. This recovery entails few problems such as allocation due to the simultaneous production of several metals, the use of non-renewable resources, and the exergy destruction during the life cycle of the metals. Therefore, this work analyses the waste printed circuit boards (PCBs) recycling process by proposing different exergy-based cost allocations for the mentioned metals, disaggregating the exergy cost into non-renewable and renewable, and considering the complete life cycle of metals with the Circular Thermoeconomics methodology. The results show a significant saving of non-renewable energy by using renewable energies in primary extraction (67-87%), recycling (97.6-98.5%), and renewable energies in recycling (98.7%, 99.0%), compared to conventional primary extraction. However, when considering the entire life cycle, between 47% and 53% of the non-renewable exergy is destroyed during recycling. Therefore, delaying recycling as much as possible would be the most desirable option for maximizing the use of non-renewable resources, which nature cannot replace in a short time.

Derivatives products have become essential in portfolio diversification, price discovery and risk hedging. Derivatives are complex instruments; their role is twofold, risk management and speculation, and their actual Impact on the underlying assets’ behaviours are not well understood. Little is documented empirically on how these instruments’ two-edged roles influence firms’ financing decisions, firm risk exposures, and stability. Given the growing interest in using derivatives in risk management and portfolio engineering, this study examines the practical impact of derivatives usage on the underlying firm’s financing policy and stability. The paper uses data from South African listed non-financial firms for the period 2000 to 2019. The study employs a dynamic panel model estimated with System Generalised Methods of Moments (GMM). The initial analysis shows that derivatives use reduces the cost of capital and increases firm stability. However, further in-depth analysis provides evidence that extensive use of derivatives increases firms’ capital costs and negatively impacts financial stability. These findings imply that the risk embedded in derivatives’ speculation dominates their risk management function. The results are subjected to numerous controls for robustness, including financial leverage, firm size, cashflows and asset tangibility.

Background: The phase III KEYNOTE-604 study confirmed the benefit of pembrolizumab combined with chemotherapy in the first-line treatment of extensive-stage small-cell lung cancer(ES-SCLC). Intergrated the clinical benefits of pembrolizumab and its high cost into account, this study aim to assess the cost-effectiveness of adding pembrolizumab to standard first-line etoposide-platinum (EP) for patients with ES-SCLC from the the US payer perspective. Methods: A Markov model was developed to compared the costs and quality-adjusted life-years (QALYs) of pembrolizumab plus EP and placebo plus EP over a 10-year time horizon. Clinical efficacy, treatment utilization and safety data were pooled from the KEYNOTE-604 trial. Utilities were obtained from published resources. Costs were mainly collected from Medicare in 2020. Sensitivity analyses were performed to examined the robustness of our model. Results: Adding pembrolizumab to standard first-line EP, resulted in better effectiveness than the use of EP alone for ES-SCLC by 0.22 QALYs. Pembrolizumab plus EP was dominated economically by placebo plus EP, leading to an incremental cost-effectiveness ratio(ICER) of $334,373/ QALY. Deterministic sensitivity analyses indicated that the uncertainty in model parameters exerts no substantial effect on our results. Probability sensitivity analysis indicated that probabilities for pembrolizumab plus EP being cost-effective within a wide rang of willingness to pay were modest. Conclusion: From the US payer perspective, the first-line treatment for ES-SCLC with pembrolizumab plus EP was not cost-effective compare with placebo plus EP. Although pembrolizumab combination chemotherapy was beneficial to the survival of ES-SCLC, price reduction may be the necessary measure to improve its cost-effectiveness.

Background: The use of peripherally inserted central catheters and midline catheters is growing due to their potential benefits. These devices can increase patient safety and satisfaction while reducing the use of resources. As a result, many hospitals are establishing vascular access specialist teams staffed by nurses who are trained in the insertion and maintenance of these catheters. Objective: Evaluate ex-ante whether the benefits of replacing peripheral venous catheters, peripherally inserted central catheters and midline catheters with ultrasound-guided peripherally inserted central catheters and midline catheters by a vascular access specialist team outweigh their costs. Methods: Cost-benefit analysis from the perspective of the healthcare provider based on administrative data. The study estimates the reduction in resources used when replacing peripherally inserted central catheters, midline catheters and peripheral venous catheters with ultrasound-guided peripherally inserted central catheters and midlines, as well as the additional resources required for their use. Results: Each ultrasound-guided peripherally inserted central catheter replacing a peripherally inserted central catheter, results in a measurable resource reduction of approximately €31. When 3 peripheral venous catheters are replaced by an ultrasound-guided peripherally inserted central catheter, the saving is €63. Similarly, each ultrasound-guided midline catheter replacing a midline, results in a reduction of €16, while each ultrasound-guided midline catheter replacing 3 peripheral venous catheters results in a reduction of €96. Conclusion: The benefits of replacing peripheral venous catheters, peripherally inserted central catheters and midline catheters by introducing a vascular access specialist team trained in the implantation of ultrasound-guided peripherally inserted central catheters and midline catheters, outweigh its cost mainly because of the decrease in hospital stay due to the lowered risk of healthcare-associated infections. These results motivate the implementation of the service, adding to previous experience suggesting that it is also preferable from the point of view of patient safety and satisfaction.

Legacy risks from infrastructures and industrial installations often reveal themselves when a potential for failure has been discovered much later than at the stage of the design and construction of a structure. In which case, there might already be a problem with the legacy installation, or even a crisis, without having had an accident. When the hazard cannot be taken away, the question arises as to how much effort, if any, should be spent on improving the situation. The usefulness of the three archetypical approaches to this problem: setting a standard, the As Low As Reasonably Practicable approach and a case-by-case discourse approach are discussed for their applicability for these legacy risks. Although it would be desirable to retrofit legacy risks to previously set legal requirements as is the case when acceptability limits are set in law or demonstration of ALARP is demanded, it may be impossible to reduce the residual risk to an otherwise acceptable level without taking away or replacing the infrastructure, which is not acceptable either. Therefor in conclusion the only available solution to persistent legacy risk problems seems to be to have a thorough discussion with all relevant stakeholders until an agreement is in some way found.

Estimation of the worth of continuity of electricity supply is of interest of industry, authorities and research society. There are numerous methods to calculate the Customer Interruption Costs (CICs). Each method has its advantages and disadvantages. This paper approaches the problem from Distribution System Operators’ (DSOs) point of view and adopts two existing analytical models. One model is used by the Finnish Energy Market Authority and the second one was proposed by the authors at a previous study. The model suggested by the authors as an alternative to the one used by the Finnish Energy Market Authority proposes a simple and straightforward methodology which will provide credible and objective estimations by only utilizing publicly available analytical data. We made use of cost and reliability indices data of 78 DSOs in Finland from the year 2016. In addition to cost estimations, this paper highlights regional differences in CIC estimations in different parts of Finland and critically overviews the existing standard customer compensation scheme in Finland.

The epidemiological situation generated by COVID-19 has highlighted the importance of applying non-pharmacological measures. Among these, mass screening of the asymptomatic general population has been established as a priority strategy by carrying out diagnostic tests to limit the spread of the virus. In this article, we aim to evaluate the economic impact of mass COVID-19 screenings of an asymptomatic population through a Cost-Benefit Analysis based on the estimated total costs of mass screening versus health gains and associated health costs avoided. Excluding the value of monetized health, the Benefit-Cost ratio was estimated at approximately 0.45. However, if monetized health is included in the calculation, the ratio is close to 1.20. The monetization of health is the critical element that tips the scales in favour of the desirability of screening. Screenings with the highest return are those that maximize the percentage of positives detected.

The response of building elements during earthquakes has been an area of concern for different researchers around the world. The NSEs are the first elements to attain failure, the buildings after damages in safety priority are classified as in “Life Safety” mode, but in reality, they are in “Collapse Safety” mode and the occupants inside the buildings are in a state of “Non-Life Safety” as a result of falling of the hazardous NSE’s like cladding's, partitions, hanging objects. In addition to the Life Cycle Cost Assessment (LCCA), the Social Life Cycle Assessment (SLCA) is overlooked by the majority of the researchers, the community must be prepared to respond to an event more efficiently without any major casualties or loss of life. It is expected that by the end of 2050, almost double the construction will take place, the embodied energy during the pre-construction, post-construction and demolition generates a lot of CO2s into the environment, hence sustainability should be given due importance, helping in the achievement of Sustainable Developmental Goals (SDGs).

As a long lifeline system of buried structures, Utility tunnel (UT) is vulnerable to earthquake invading. For utility tunnels with inverted siphon arrangement crossing the river, the seismic response is more complex due to the basin effect of acceleration in the topography and the influence of fluctuating hydrodynamic pressure. Based on a UT project in Haikou, this paper studied seismic response of cast-in-place UT considering the coupled model of water-soil-tunnel structure on ABAQUS software. Herein, the dynamic fluctuation of hydrodynamic pressure is simulated using acoustic-solid interaction model. A viscoelastic artificial boundary was used to simulate the soil boundary effect, and seismic loads were equivalent to nodal forces. Considering seismic invading direction and varying water elevation, the paper investigates the dynamic response characteristics and damage mechanisms of river-crossing utility tunnels. The study shows that basin effects cause the different acceleration amplifying of the soil around the UT in different sections, and the greater damage to the tunnels in bidirectional seismic excitation, which the damage concentrated at the junction of the transition between the horizontal section and the vertical section; Bending moments and axial forces are the dominant mechanical behaviors along the axial direction; and the river water level change influences the internal distribution of the tunnels, showing a certain amount of energy dissipation and seismic damping effects. For the aseismic design of cross-river cast-in-place utility tunnels, bidirectional seismic calculations should be performed, and the influence of river hydrodynamic pressure should not be neglected.

Here I describe an overlooked form of non-biological paralife (i.e., near-life) that has been evolving on Earth for millions of years, and is currently in the final stages of transitioning into a new form of life. Any consideration of non-biological life or paralife is complicated by the fact that there is no consensus among biologists for the definition of life. This ambiguity has caused disagreement about whether subcellular reproduction systems like viruses are a form of life, despite having genomes, mutations, heritable phenotypes and system-improving evolution. To resolve this problem, I develop a definition of life that is entirely functional and independent of any of the structural idiosyncrasies of biological life on Earth: an order-generating system controlled by internally-encoded information that perpetuates itself by functioning to counteract its entropic decay. Using this definition, subcellular transposons, plasmids, and viruses are paralife because they match the definition of life in all ways except that they induce their order-generating functioning by a living host rather through their own self-sustaining production system. Using this functional definition of life, I show that utility- products (UPs) like fabricated hand tools are part of induced-reproduction systems that have features equivalent to biological genomes, mutations, heritable phenotypes, and a process of system-improving evolution. The perceived benefit of utility-products causes them to induce their reproduction by a biological life-form (humans). For these reasons, human utility products are functionally just as close to being a form of life as subcellular transposons, plasmids, and viruses, i.e., they are Utility-Product paralife (UP-parlife). I also show that some forms of UP-paralife are currently evolving into mechanical life that is capable of both self- sustaining reproduction and system-improving evolution without outside assistance. This transition requires the development of a high level of factory and/or UP automation and artificial intelligence (AI) that is capable of complex reasoning, imagination and creativity. Finally, I consider the influence of UP-life and UP-paralife on the development of the level of structural complexity in the universe, and I briefly speculate about how these non-biological forms of life and paralife will influence the expansion of scientific knowledge about the universe.

While the foundations of climate science and ethics are well established, fine-grained climate predictions, as well as policy-decisions, are beset with uncertainties. This chapter maps climate uncertainties and classifies them as to their ground, extent and location. A typology of uncertainty is presented, centered along the axes of scientific and moral uncertainty. This typology is illustrated with paradigmatic examples of uncertainty in climate science, climate ethics and climate economics. Subsequently, the chapter discusses the IPCC’s preferred way of representing uncertainties and evaluates its strengths and weaknesses from a risk management perspective. Three general strategies for decision-makers to cope with climate uncertainty are outlined, the usefulness of which largely depends on whether or not decision-makers find themselves in a context of deep uncertainty. The chapter concludes by offering two recommendations to ease the work of policymakers, faced with the various uncertainties engrained in climate discourse.

A micro decision-making utility model under uncertainty is presented as a complementary foundation for macro coronavirus models. The micro model consists of two functions, a risk averse utility function depending on wellness and a wellness random output which is a function of the input variable called “treatment” consisting of such elements as social distance, washing hands, wearing a face mask, and others. The decision maker selects a level of treatment that maximizes her/his expected utility, given the probabilities of the respective outputs. The focus is on how changes in a person’s psychological attitude towards the macro determined (announced) probabilities affects the optimum results of the model. Such changes create a micro-macro dynamic interaction which is briefly outlined. A short discussion of the model’s behavioral implications for health policy is also given.

Background/Objectives: The study outlines the systematic approach taken to develop and apply a robust NLP algorithm to determine the necessity of performing routine imaging after central venous catheter (CVC) placement and removal, based on the incidence of pneumothorax observed. Methods: Electronic health records from four university hospitals in Salzburg, Austria, on X-rays performed between 2012 and 2021 following CVC procedures, were analyzed using an NLP al-gorithm. The algorithm detected a pneumothorax in radiologists' reports and clinician requests, while excluding cases with contraindications such as chest injuries, prior pneumothorax, missing data, or unrelated follow-up X-rays. Chi-square tests were used to compare pneumothorax rates between CVC insertion and removal, and multivariate logistic regression identified risk factors, with a focus on age and gender. Results: The study analyzed 17,175 cases of patients aged 18 and older, with 95.4% involving CVC insertion and 4.6% involving CVC removal. Pneumothorax was identified in 106 cases after insertion (1.3%) and in 3 cases after removal (0.02%). The Chi-square test showed no statistically significant difference in pneumothorax incidence between insertion and removal (p = 0.4797), in-dicating no substantial difference in pneumothorax risk between these procedures. Conclusions: Given the lack of significant difference in pneumothorax incidence between CVC insertion and removal, and the established consensus that routine imaging is unnecessary after CVC removal, these findings indicate that routine imaging following CVC insertion may also be unnecessary in asymptomatic patients.

This paper focuses on quantifying the economic and financial viability of NB-IoT and LoRaWAN technologies, two low-power wide-area network (LPWAN) technologies with unique characteristics that make them suitable for IoT applications. The purpose of the study is to propose an artefact for performing life cycle cost analysis and demonstrate its application to these technologies. The methodology uses pragmatic computational tools to facilitate the analysis and considers all relevant economic and financial factors, such as operating costs, equipment costs, and revenue potential. The main finding of the study is that NB-IoT and LoRaWAN technologies have different cost structures and revenue potentials, which may affect their economic and financial viability for different IoT applications. Ultimately, the study concludes that a comprehensive life cycle cost analysis is critical to making informed decisions about technology adoption, and that the proposed methodology can be applied to other IoT technologies to gain insight into their economic and financial viability.

The objective of this paper was to give an overview of the expressed preference (EP) techniques of environmental valuation. These methods offer estimation of the value of a resource not necessarily willingness to pay (WTP) or willingness to Accept (WTA) compensation rather upper and lower values. The method of measuring individuals’ willingness to pay is usually based on contingent valuation method (CVM). This research focuses on defining, categorizing, and applicability of various environmental valuation techniques that have been and can be applied in attaching value to a given resource using expressed/Revealed preference methods. The study serves as a supplementary synthesis and discussion to the board of knowledge of resource valuation methods. More specifically, selected methods to discussed herein include; contingent valuation method, hedonic pricing model, travel cost method, trade-off game method, the costless-choice method, Delphi method, Replacement Cost Method, Relocation Cost Method, Opportunity cost method, and Cost-benefit Method. In the last part, applicability of the methods is fully illustrated to support future studies on resource valuation.

Umbria is an Italian region with a highly fragmented water supply, with many small water distribution systems fed by local sources. The chlorination in these small water systems faces many difficulties related to the high demand variation, low economic relevance, and access to infrastructures. As a result, there are many noncompliances with the quality of the supplied water, which causes a decrease in the performance indicators and tariff. This research investigates the possibility of using a low-cost chlorination system to consider different environmental conditions (e.g., temperature variations of water and environment, pH, ...) and discontinuous consumption. A device for this specific use is developed and tested by laboratory tests and is ready for use in the field.

Tropical rock lobsters (Panulirus ornatus) are a highly cannibalistic species with intermoult animals predominantly attacking animals during ecdysis (moulting). Rapid, positive characterisation of pre-ecdysis lobsters may open a pathway to disrupt cannibalism. Ecdysial suture line development is considered for pre-ecdysis recognition with suture line definition compared for lobsters emerged and immerged, using white, near ultraviolet (365 nm), near infrared (850 nm) and spe-cialty Osram SFH 4737 broadband IR LEDs against a reference of intermoult lobsters with no suture line development. An alternative pre-ecdysis recognition strategy used a novel low-cost spectral camera composed of the Sony IMX219, AMS AS7265x spectral sensors and Osram SFH 4737 broadband infrared LEDs. Images and data using the novel low-cost spectral camera was acquired from intermoult, pre-ecdysis, and post-ecdysis lobsters. Compared with the white light appear-ance, suture line definition was enhanced under 850 nm, 365 nm, and SFH 4737 LEDs for immerged lobsters, while the 850 nm LED achieved the best suture line definition of emerged lobsters. The spectral camera was unable to characterise pre-ecdysis. A least squares regression for binary classification decision boundary successfully separated 86.7% of post-moult lobsters. Achieving post-moult characterisation validated the speculative exploratory approach in developing this novel low-cost spectroscopy tool.

GNSS is nowadays a standard tool for monitoring and studying the Earth’s dynamic environment. However, the development of dense GNSS measurements remains limited in many experiments by the cost of geodetic-class equipments allowing to achieve the high precision required by many applications. Recently, multi-constellation, multi-frequency, low-power and, above all, less expensive GNSS electronic chips have become available. We present a prototype of a low-cost, open-source multi-GNSS station. Our prototype comprises a dual-frequency GNSS chip, a calibrated antenna, a Raspberry Pi card and a 4G key for data transmission. The system is easy to deploy in the field and allows precise positioning in real time and post-processing. We assess the performance of our prototype in terms of raw data quality, and quality of the obtained high rate and daily position one-year-long time series. Our results demonstrate a quality equivalent to geodetic-class equipment and better quality than other low-cost systems proposed so far.

Peste des Petits Ruminants (PPR), a highly contagious viral disease, causes significant economic losses in sheep and goats. Laboratory diagnosis is crucial to disease control and eradication. Since PPRVs have recently adopted new hosts, genetic diversity within isolates of the same lineage is more likely than if they were host-specific, sheep and goats most often. ELISA detects antibodies and antigens in serology. However, mishandling, environmental conditions (temperature and humidity), storage, and sensitivity issues of commercially available ELISA kits prevent rapid PPR virus detection in third-world countries like Pakistan. In the 2020-21 outbreaks in Pakistan, 325 blood samples, 19 swabs, and 6 virus tissue samples of sheep and goats were collected from Gilgit, Islamabad, and Fateh Jang. These virus isolates were submitted to NCBI for partial N gene sequencing. Antigen was prepared from indigenous virus Using semi-purified antigen from PPRV, an indirect ELISA for the detection of PPR antibodies in goat and sheep serum was developed using MW600922 grown in Vero cells. Dilutions of 1:200 serums and 1:32 antigens improve antibody detection. The N-gene-based analysis revealed a better understanding of PPRV genetic characterization. This study develops an RT-PCR assay to detect PPRV by targeting the N-protein gene. This assay offers an accurate and affordable diagnostic tool for PPRV and partial genome sequencing. Results described that PPRV isolates from the current study have 99.73% and 99.4% similarity to previously published Lahore and Faisalabad isolates from Pakistan, respectively. Compared to previous isolates from NCBI data, the virus showed high divergence rates with the Turkish strain. The comparative analysis between Commercial kit (c-ELISA) and I-ELISA revealed that the former had a high sensitivity of 90.60% and specificity of 85.23% compared with the cELISA kit. By comparing I-ELISA and VNT, we find that the current assay is 100% specific and 82.14 % sensitive. Based on these results, serological surveys for PPR antibodies, on a larger scale, in small ruminants can be conducted with indirect ELISA rather than competitive ELISA. Furthermore, the cost and storage efficiency was highly significant because the currently developed method has a low production cost, which is much lesser than the commercially available kit. Our findings demonstrated a significant breakthrough in terms of cost-effectiveness and storage efficiency, and they are highly recommended for developing countries.

This paper presents high-resolution digital measurements at low cost, combining oversample and averaging. Experiments of processing data between samples and between multiple temperature sensors in the same environment are conducted. They provide results with effective increase in the analog to digital converter bits, in correspondence with the minimization on the effects of noise. It is shown that averaging a set of small, low-cost sensors at a small microcontroller can give flexible access to improved measurement accuracy.

We review some semantical aspects of probability bounds from Boole’s “conditions on possible experience” violated by quantum mechanics. We also speculate about emerging space-time categories as an epiphenomenon of quantization and the resulting breakdown of relativity theory by non-unitary and non-linear processes.

OBJETIVES: During the COVID-19 pandemic, the risk of collapse of the health system created great difficulties. We will demonstrate that Intermediate Respiratory Care Units (IRCU) provide adequate management of patients with non-invasive respiratory support, which is particularly important in patients with SARS-CoV-2 pneumonia. METHODS: A prospective observational study of patients with COVID-19 admitted to the ICU of a tertiary hospital. Sociodemographic data, comorbidities, pharmacological, respiratory support, laboratory and blood gas variables were collected. The overall cost of the unit was subsequently analyzed. RESULTS: 991 patients were admitted, 56 to the IRCU (of the 81 a critical care unit). Mean age was 65 years (SD 12.8), Barthel Index 75 (SD 8.3), Charlson 3.1 (SD 2.2), HTN 27%, COPD 89% and obesity 24%. Significant relationship (p <0.05) with higher mortality of the following: fever greater than or equal to 39oC [OR 5.6; 95% CI (1.2-2.7); p = 0.020], protocolized pharmacological treatment [OR 0.3; 95% CI (0.1-0.9); p = 0.023] and IOI [OR 3.7; 95% CI (1.1-12.3); p = 0.025]. NIMV showed less of a negative impact [OR 1.8; 95% CI (0.4-8.4); p = 0.423] than IOI. The total cost of the IRCUs amounted to €66,233. The cost per day of stay in the IRCU was €164 per patient. The total cost avoided was €214,865. CONCLUSION: The pandemic has highlighted the importance of IRCUs in facilitating the management of a high patient volume. The treatment carried out in IRCUs is effective and efficient, reducing both admissions to and stays in the ICU.

The domain of Information and Communication Technology (ICT) education has garnered significant consideration in recent times. However, several challenges are inherent to this area of study, including monetary expense, temporal factors, pedagogical environment, teacher training programs, incentive, syllabus design, and health-related concerns. This paper presents an analysis of the difficulties encountered in the realm of ICT education in Japan, taking into account ten different perspectives.

The aim of this article is to propose a core game theory model of transaction costs wherein it is indicated how direct costs determine the probability of loss and subsequent transaction costs. The existence of optimum is proven, and the way in which exposure influences the location of the optimum is demonstrated. The decisions are described as a two-player game and it is discussed how the transaction cost sharing rule determines whether the optimum point of transaction costs is the same as the equilibrium of the game. The dispute between actors regarding changing the share of transaction costs to be paid by each party is modeled by a non-cooperative bargaining game. Requirements of efficient transaction cost sharing rules are defined, and it is posited that solution exists which is not unique. Policy conclusions are also devised based on principles of design of institutions to influence the nature of transaction costs.

The present work studies the concept of productivity in shipbuilding and how it should be measured. The existing metrics, shipbuilding process and shipyard organization were studies in order to choose the most adequate metrics which would allow the measuring of a shipyard productivity in a systematic and holistic way. This is achieved by gathering the man-hours spent in each ship organized by cost centre and using Compensated Gross Tonnages as the measure of output from the shipyard. Data was gathered for thirty ships built in the same European yard organized by cost centre. From the data collected it was found that the ratio of hours spent in outfitting to the hours spent in structures is proportional to the complexity of the ship. There was also opportunity to study the work reduction resulting from building ships in series and the shares of labour for ships series and across ship types.