Search results for: healthcare costs

Authors: Youssef El Makhrout, Aude Pommeret, Tunç Durmaz

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This paper analyses the consequences of a heat pump on the optimal behavior of a prosumer. A theoretical microeconomic model is developed for household heating and electricity consumption to analyze the profitability of installing a solar PV system with a heat pump, battery storage, and grid use. The aim is to present the optimal scenario of investment in renewable energy equipment to cover domestic and heating needs. Simulation data of a French house of 170m² in Chambery are used in this paper. The house is divided into 5 zones with 3 heated zones of 89.4 m² occupied by two people. The analysis is based on hourly data for one year, from 00:00 01/01/2021 to 23:00 31/12/2021. Results indicate that without taking the cost of materials and no financial aid, the most profitable scenario for a household is when he owns solar panels, a heat pump, and battery storage. However, with the costs and financial aid of the French government for energy renovation, the net economic surplus change and the profitability during 20 years are important when the household decides to add a heat pump to existing solar panels. In this scenario, the household can realize 35.84% as a surplus change improvement, but this cannot cover all installation costs. The household can get benefits and cover all installation costs after exploiting financial support in the case of adopting a heat pump. The investment in a battery is still not profitable because of its high cost and the lack of financial aid. Some public policy recommendations are proposed, especially for solar panels and battery storage.

Keywords: household’s heating, prosumer, electricity consumption, renewable energy, welfare gain, comfort, solar PV, heat pumps, storage

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Authors: Anita Paddy, Millicent Obodai, Lebbaeus Asamani

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The management of sickle cell disease requires a multidisciplinary team for better outcomes. Thus, literature on the application of the biopsychosocial model for the management and explanation of chronic pain in sickle cell disease (SCD) and other chronic diseases abound. However, there is limited research on the use of the biopsychosocial model, together with a spiritual component (biopsychosocial-spiritual model). The study investigated the extent to which healthcare providers utilized the biopsychosocial-spiritual model in the management of chronic pain to improve the quality of life (QoL) of patients with SCD. This study employed the descriptive survey design involving a consecutive sampling of 261 patients with SCD who were between the ages of 18 to 79 years and were accessing hematological services at the Clinical Genetics Department of the Korle Bu Teaching Hospital. These patients willingly consented to participate in the study by appending their signatures. The theory of integrated quality of life, the gate control theory of pain and the biopsychosocial(spiritual) model were tested. An instrument for the biopsychosocial-spiritual model was developed, with a basis from the literature reviewed, while the World Health Organisation Quality of Life BREF (WHOQoLBref) and the spirituality rating scale were adapted and used for data collection. Data were analyzed using descriptive statistics (means, standard deviations, frequencies, and percentages) and partial least square structural equation modeling. The study revealed that healthcare providers had a great leaning toward the biological domain of the model compared to the other domains. Hence, participants’ QoL was not fully improved as suggested by the biopsychosocial(spiritual) model. Again, the QoL and spirituality of patients with SCD were quite high. A significant negative impact of spirituality on QoL was also found. Finally, the biosocial domain of the biopsychosocial-spiritual model was the most significant predictor of QoL. It was recommended that policymakers train healthcare providers to integrate the psychosocial-spiritual component in health services. Also, education on SCD and its resultant impact from the domains of the model should be intensified while health practitioners consider utilizing these components fully in the management of the condition.

Keywords: biopsychosocial (spritual), sickle cell disease, quality of life, healthcare, accra

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Authors: Nikhil Yadav, Shubham Verma

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Gas lift is a common technique used to optimize oil production in wells. Prosper software is a powerful tool for modeling and optimizing gas lift systems in oil wells. This review paper examines the effectiveness of Prosper software in optimizing gas lift systems in oil-producing wells. The literature review identified several studies that demonstrated the use of Prosper software to adjust injection rate, depth, and valve characteristics to optimize gas lift system performance. The results showed that Prosper software can significantly improve production rates and reduce operating costs in oil-producing wells. However, the accuracy of the model depends on the accuracy of the input data, and the cost of Prosper software can be high. Therefore, further research is needed to improve the accuracy of the model and evaluate the cost-effectiveness of using Prosper software in gas lift system optimization

Keywords: gas lift, prosper software, injection rate, operating costs, oil-producing wells

Procedia PDF Downloads 58

Authors: A. Alrasheed, I. Connerton

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Providing patients with safe meals on a daily basis is one of the challenges in the healthcare sector. In Saudi Arabia matters related to food safety and hygiene have been the heart of the Ministry of Health (MOH) and Saudi Food and Drugs Authority (SFDA). The aim of this study is to examine the causes of inadequate implementation of food safety management systems such as HACCP in Riyadh’s MOH hospitals. By the law, food safety must be managed using a documented, HACCP based approach, and food handlers must be appropriately trained in food safety. Food handlers in Saudi Arabia are not required to provide a certificate or attend a food handling training course even in healthcare sectors. Since food safety and hygiene issues are of increasing importance for Saudi Arabian health decision makers, the SFDA has been established to apply food hygiene requirements in all food operations. It should be pointed out that the implications of food outbreaks on the whole society may potentially go beyond individual health impacts but also impact on the Nation’s health and bring about economic repercussions.

Keywords: food safety, patient, hospital, HACCP

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Authors: Ho-Jun Jo, Wook-Won Kim, Yong-Sung Kim, Jin-O Kim

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The application of ESS (Energy Storage Systems) in the future grids has been the solution of the microgrid. However, high investment costs necessitate accurate modeling and control strategy of ESS to justify its economic viability and further underutilization. Therefore, the reasonable control strategy for ESS which is subjected to generator and usage helps to curtail the cost of investment and operation costs. The rated frequency in power system is decreased when the load is increasing unexpectedly; hence the thermal power is operated at the capacity of only its 95% for the Governor Free (GF) to adjust the frequency as reserve (5%) in practice. The ESS can be utilized with governor at the same time for the frequency response due to characteristic of its fast response speed and moreover, the cost of ESS is declined rapidly to the reasonable price. This paper presents the ESS control strategy to extend usage of the ESS taken account into governor’s ramp rate and reduce the governor’s intervention as well. All results in this paper are simulated by MATLAB.

Keywords: micro grid, energy storage systems, ramp rate, control strategy

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Authors: Xavier Ruiz Del Portal

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This paper incorporates mobility between the legal and black economies into a model of tax evasion with endogenous labor supply in which underreporting is possible in one sector but impossible in the other. We have found that the results of the effects along the extensive margin (number of evaders) become more robust and conclusive than those along the intensive margin (hours of illegal work) usually considered by the literature. In particular, it is shown that the following policies reduce the number of evaders: (a) larger and more progressive evasion penalties; (b) higher detection probabilities; (c) an increase in the legal sector wage rate; (d) a decrease in the moonlighting wage rate; (e) higher costs for creating opportunities to evade; (f) lower opportunities to evade, and (g) greater psychological costs of tax evasion. When tax concealment and illegal work also are taken into account, the effects do not vary significantly under the assumptions in Cowell (1985), except for the fact that policies (a) and (b) only hold as regards low- and middle-income groups and policies (e) and (f) as regards high-income groups.

Keywords: income taxation, tax evasion, extensive margin responses, the penalty system

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Authors: I. Teotónio, C.O. Cruz, C.M. Silva, M. Manso

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Diverse stakeholders show different concerns when choosing green roof systems. Also, green roof solutions vary in their cost and performance. Therefore, decision-makers continually face the difficult task of balancing benefits against green roofs costs. Decision analysis methods, as multicriteria analysis, can be used when the decision‑making process includes different perspectives, multiple objectives, and uncertainty. The present study adopts a multicriteria decision model to evaluate the installation of green roofs in buildings, determining the solution with the best trade-off between costs and benefits in agreement with the preferences of the users/investors. This methodology was applied to a real decision problem, assessing the preferences between different green roof systems in an existing building in Lisbon. This approach supports the decision-making process on green roofs and enables robust and informed decisions on urban planning while optimizing buildings retrofitting.

Keywords: decision making, green roofs, investors preferences, multicriteria analysis, sustainable development

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Authors: Hamim Abbas, Jean Luc-Hornick, Isabelle Dufrasne

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Feed costs constitute over 60% of total expenses in organic layer poultry production, with feed protein supply being a significant concern. Alfalfa-based dehydrated silage pellets are mainly diets composed of leaves (ABSP), which are non-conventional protein sources that could enhance profits by reducing feed costs and ensuring consistent availability. This experiment studied the effects on the performances of Novogen Brown light layers of a commercial control diet replaced with 10% ABSP. After a 21-day trial, this diet (ABSP) has improved the laying rate, yolk color of eggs, feed conversion rate, ω−3 (PUFAs) and ω−6/ω−3 ratio (P<0.05) while the body weight and egg weight were degraded with the substitution of the ABSP in the diet(P>0.05). The laying rate showed a tendency to increase (P=0.06). These findings suggest that ABSP can replace at least 10% of the feed in organic layer diets without compromising production parameters negatively.

Keywords: alfalfa, silage, pellet, organic layers

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Authors: Riina I. Bray, Yifan Wang, Nikolas Argiropoulos, Stephanie Robins, John Molot, Kelly Tragash, Lynn M. Marshall, Margaret E. Sears, Marie-Andrée Pigeon, Michel Gaudet, Pierre Auger, Emily Bélanger, Rohini Peris

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Multiple chemical sensitivity (MCS) is a chronic medical condition characterized by intolerances to chemical substances. Since the arrival of the COVID-19 pandemic and associated health measures, people experiencing MCS (PEMCS) are at a heightened risk of environmental exposures associated with cleaners, disinfectants, and sanitizers. Little attention has been paid to the well-being of PEMCS in the context of the COVID-19 pandemic. Objective: This study assesses the lived experiences of Canadian adults with MCS in relation to their living environment, access to healthcare, and levels of perceived social support before and during the pandemic. Methods: A total of 119 PEMCS completed an online questionnaire. McNemar Chi-Squared and Wilcoxon Signed Rank tests were used to evaluate if there were statistically significant changes in participants’ perception of their living environment, access to healthcare, and levels of social support before and after March 11, 2020. Results: Both positive and negative outcomes were noted. Participants reported an increase in exposure to disinfectants/sanitizers that entered their living environment (p<.001). There was a reported decrease in access to a family doctor during the pandemic (p<0.001). Although PEMCS experienced increased social isolation (p<0.001), they also reported an increase in understanding from family (p<0.029) and a decrease in stigma for wearing personal protective equipment (p<0.001). Conclusion: PEMCS reported experiencing: increased exposure to disinfectants or sanitizers, a loss of social support, and barriers in accessing healthcare during the pandemic. However, COVID-19 provided an opportunity to normalize the living conditions of PEMCS, such as wearing masks and social isolation. These findings can guide decision-makers on the importance of implementing nontoxic alternatives for cleaning and disinfection, as well as improving accommodation measures for PEMCS.

Keywords: covid-19, multiple chemical sensitivity, MCS, quality of life, social isolation, physical environment, healthcare

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Authors: N. Beit Saeid

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Cyclones are used in the field of air industrial gases pollution and control the pollution with centrifugal forces that is generated with spatial geometry of the cyclone. Their simple design, low capital and maintenance costs and adaptability to a wide range of operating conditions have made cyclones one of the most widely used industrial dust collectors. Their cost of operation is proportional to the fan energy required to overcome their pressure drop. Optimized geometry of outlet diffuser of the cyclones potentially could reduce exit pressure losses without affecting collection efficiency. Three rectangular outlets and a radial outlet with a variable opening had been analyzed on two cyclones. Pressure drop was investigated for inlet velocities from about 10 to 20 m s−1. The radial outlet reduced cyclone pressure drop by between 8.7 and 11.9 percent when its exit area was equal to the flow area of the cyclone vortex finder or gas exit. A simple payback based on avoided energy costs was estimated to be between 3600 and 5000 h, not including installation cost.

Keywords: cyclone, CFD, optimization, genetic algorithm

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Authors: Nomcebo N. Mpili, Cynthia Z. Madlabana

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The South African Primary Health Care (PHC) system has undergone a number of transformations such as the introduction of National Health Insurance (NHI) to bring about easily accessible universal health coverage and to meet the health needs for all its citizens. This provides ongoing challenges to ensure that health workers are equipped with appropriate knowledge, support, and skills to meet these changes. Therefore it is crucial to understand the experiences and challenges of nurses as the backbone of PHC in providing quality healthcare services. In addition there has been a need to understand nurses’ experiences with management support, role ambiguity and role conflict amongst other challenges in light of the current reforms in healthcare. Indeed these constructs are notorious for having a detrimental impact on the outcomes of change initiatives within any organisation, this is no different in healthcare. This draws a discussion on professional nurses within the South African health care system especially since they have been labelled as the backbone of PHC, meaning any healthcare backlog falls on them. The study made use of semi-structured interviews and adopted the interpretative phenomenological approach (IPA) as the researcher aimed to explore the lived experiences of (n= 18) participants. The study discovered that professional nurses experienced a lack of management support within PHC facilities and that management mainly played an administrative and disciplinary role. Although participants mainly held positive perceptions with regards to changes happening in health care however they also expressed negative experiences in terms of how change initiatives were introduced resulting in role conflict and role ambiguity. Participants mentioned a shortage of staff, inadequate training as well as a lack of management support as some of the key challenges faced in facilities. This study offers unique findings as participants have not only experienced the various reforms within the PHC system however they have also been part of NHI pilot. The authors are not aware of any other studies published that examine management support, role conflict and role ambiguity together especially in South African PHC facilities. In conclusion understanding these challenges may provide insight and opportunities available to improve the current landscape of PHC not only in South Africa but internationally.

Keywords: management support, professional nurse, role ambiguity, role conflict

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Authors: Kim Young-Jin, Kim Byung-Kon

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Although more efforts to expand the application of BIM (Building Information Modeling) technologies have be pursued in recent years than ever, it’s true that there have been various challenges in doing so, including a lack or absence of relevant institutions, lots of costs required to build BIM-related infrastructure, incompatible processes, etc. This, in turn, has led to a more prolonged delay in the expansion of their application than expected at an early stage. Especially, attempts to save costs for building BIM-related infrastructure and provide various BIM services compatible with domestic processes include studies to link between BIM and cloud computing technologies. Also in this study, the author attempted to develop a cloud BIM service operation model through analyzing the level of BIM applications for the construction sector and deriving relevant service areas, and find how to link BIM services to the cloud operation model, as through archiving BIM data and creating a revenue structure so that the BIM services may grow spontaneously, considering a demand for cloud resources.

Keywords: construction IT, BIM (building information modeling), cloud computing, BIM service based cloud computing

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Authors: Lavanya Annadi, Fahimeh Jafari

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Transportation brings immense benefits to society, but it also has its costs. Costs include such as the cost of infrastructure, personnel and equipment, but also the loss of life and property in traffic accidents on the road, delays in travel due to traffic congestion and various indirect costs in terms of air transport. More research has been done to identify the various factors that affect road accidents, such as road infrastructure, traffic, sociodemographic characteristics, land use, and the environment. The aim of this research is to predict the probabilistic crash prediction of vehicles using machine learning due to natural and structural reasons by excluding spontaneous reasons like overspeeding etc., in the United States. These factors range from weather factors, like weather conditions, precipitation, visibility, wind speed, wind direction, temperature, pressure, and humidity to human made structures like road structure factors like bump, roundabout, no exit, turning loop, give away, etc. Probabilities are dissected into ten different classes. All the predictions are based on multiclass classification techniques, which are supervised learning. This study considers all crashes that happened in all states collected by the US government. To calculate the probability, multinomial expected value was used and assigned a classification label as the crash probability. We applied three different classification models, including multiclass Logistic Regression, Random Forest and XGBoost. The numerical results show that XGBoost achieved a 75.2% accuracy rate which indicates the part that is being played by natural and structural reasons for the crash. The paper has provided in-deep insights through exploratory data analysis.

Keywords: road safety, crash prediction, exploratory analysis, machine learning

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Authors: Massimo Ferrari, Maria Sole Pagliari

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Pollution is a classic example of economic externality: agents who produce it do not face direct costs from emissions. Therefore, there are no direct economic incentives for reducing pollution. One way to address this market failure would be directly taxing emissions. However, because emissions are global, governments might as well find it optimal to wait let foreign countries to tax emissions so that they can enjoy the benefits of lower pollution without facing its direct costs. In this paper, we first document the empirical relation between pollution and economic output with static and dynamic regression methods. We show that there is a negative relation between aggregate output and the stock of pollution (measured as the stock of CO₂ emissions). This relationship is also highly non-linear, increasing at an exponential rate. In the second part of the paper, we develop and estimate a two-country, two-sector model for the US and the euro area. With this model, we aim at analyzing how the public sector should respond to higher emissions and what are the direct costs that these policies might have. In the model, there are two types of firms, brown firms (which produce a polluting technology) and green firms. Brown firms also produce an externality, CO₂ emissions, which has detrimental effects on aggregate output. As brown firms do not face direct costs from polluting, they do not have incentives to reduce emissions. Notably, emissions in our model are global: the stock of CO₂ in the economy affects all countries, independently from where it is produced. This simplified economy captures the main trade-off between emissions and production, generating a classic market failure. According to our results, the current level of emission reduces output by between 0.4 and 0.75%. Notably, these estimates lay in the upper bound of the distribution of those delivered by studies in the early 2000s. To address market failure, governments should step in introducing taxes on emissions. With the tax, brown firms pay a cost for polluting hence facing the incentive to move to green technologies. Governments, however, might also adopt a beggar-thy-neighbour strategy. Reducing emissions is costly, as moves production away from the 'optimal' production mix of brown and green technology. Because emissions are global, a government could just wait for the other country to tackle climate change, ripping the benefits without facing any costs. We study how this strategic game unfolds and show three important results: first, cooperation is first-best optimal from a global prospective; second, countries face incentives to deviate from the cooperating equilibria; third, tariffs on imported brown goods (the only retaliation policy in case of deviation from the cooperation equilibrium) are ineffective because the exchange rate would move to compensate. We finally study monetary policy under when costs for climate change rise and show that the monetary authority should react stronger to deviations of inflation from its target.

Keywords: climate change, general equilibrium, optimal taxation, monetary policy

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Authors: Laleh Boroumand, Muhammad Shiraz, Abdullah Gani, Rashid Hafeez Khokhar

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Cloud computing being the use of hardware and software that are delivered as a service over a network has its application in the area of health care. Due to the emergency cases reported in most of the medical centers, prompt for an efficient scheme to make health data available with less response time. To this end, we propose a mobile global healthcare village (MGHV) model that combines the components of three deployment model which include country, continent and global health cloud to help in solving the problem mentioned above. In the creation of continent model, two (2) data centers are created of which one is local and the other is global. The local replay the request of residence within the continent, whereas the global replay the requirements of others. With the methods adopted, there is an assurance of the availability of relevant medical data to patients, specialists, and emergency staffs regardless of locations and time. From our intensive experiment using the simulation approach, it was observed that, broker policy scheme with respect to optimized response time, yields a very good performance in terms of reduction in response time. Though, our results are comparable to others when there is an increase in the number of virtual machines (80-640 virtual machines). The proportionality in increase of response time is within 9%. The results gotten from our simulation experiments shows that utilizing MGHV leads to the reduction of health care expenditures and helps in solving the problems of unqualified medical staffs faced by both developed and developing countries.

Keywords: cloud computing (MCC), e-healthcare, availability, response time, service broker policy

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Authors: Haripriya Chakraborty

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The healthcare system in the United States is considered to be one of the most inefficient and expensive systems when compared to other developed countries. Consequently, there are persistent concerns regarding the overall functioning of this system. For instance, the large number of uninsured individuals and high premiums are pressing issues that are shown to have a negative effect on health outcomes with possible life-threatening consequences. The Affordable Care Act (ACA), which was signed into law in 2010, was aimed at improving some of these inefficiencies. This paper aims at providing a computational mechanism to examine some of these inefficiencies and the effects that policy proposals may have on reducing these inefficiencies. Agent-based modeling is an invaluable tool that provides a flexible framework to model complex systems. It can provide an important perspective into the nature of some interactions that occur and how the benefits of these interactions are allocated. In this paper, we propose a novel and versatile agent-based model with realistic assumptions to simulate the dynamics of a health insurance marketplace that contains a mixture of private and public insurers and individuals. We use this model to analyze the characteristics, motivations, payoffs, and strategies of these agents. In addition, we examine the effects of certain policies, including some of the provisions of the ACA, aimed at reducing the uninsured rate and the cost of premiums to move closer to a system that is more equitable and improves health outcomes for the general population. Our test results confirm the usefulness of our agent-based model in studying this complicated issue and suggest some implications for public policies aimed at healthcare reform.

Keywords: agent-based modeling, healthcare reform, insurance markets, public policy

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Authors: Enido Fabiano de Ramos, Ieda Kanashiro Makiya, Francisco I. Giocondo Cesar

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This study investigates the application of Digital Twins (DT) in Smart Hospital Environments (SHE), through a bibliometric study and literature review, including comparison with the principles of Industry 4.0. It aims to analyze the current state of the implementation of digital twins in clinical and non-clinical operations in healthcare settings, identifying trends and challenges, comparing these practices with Industry 4.0 concepts and technologies, in order to present a basic framework including stages and maturity levels. The bibliometric methodology will allow mapping the existing scientific production on the theme, while the literature review will synthesize and critically analyze the relevant studies, highlighting pertinent methodologies and results, additionally the comparison with Industry 4.0 will provide insights on how the principles of automation, interconnectivity and digitalization can be applied in healthcare environments/operations, aiming at improvements in operational efficiency and quality of care. The results of this study will contribute to a deeper understanding of the potential of Digital Twins in Smart Hospitals, in addition to the future potential from the effective integration of Industry 4.0 concepts in this specific environment, presented through the practical framework, after all, the urgent need for changes addressed in this article is undeniable, as well as all their value contribution to human sustainability, designed in SDG3 – Health and well-being: ensuring that all citizens have a healthy life and well-being, at all ages and in all situations. We know that the validity of these relationships will be constantly discussed, and technology can always change the rules of the game.

Keywords: digital twin, smart hospital, healthcare operations, industry 4.0, SDG3, technology

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Authors: Hani Malik

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Background: Clinician burnout is a growing phenomenon in current health systems worldwide. Increasing emotional exhaustion, depersonalisation, and reduced personal accomplishment threaten the effective delivery of healthcare. This can potentially be mitigated by mindfulness practice, which has shown promising results in reducing burnout, restoring compassion, and preventing moral injury in clinicians. Objectives: To conduct a scoping review and identify high-quality studies on mindfulness practice in clinician burnout, synthesize themes that emerge from these studies, and discuss the implications of the results to healthcare leadership and innovation. Methodology: A focused scoping review was carried out to investigate the effects of mindfulness practice on clinician burnout. High-ranking journals were targeted to analyse high-quality studies and synthesize common themes in the literature. Studies conducted on current, practicing physicians were included. Mindfulness practice of varying forms was the main intervention studied. Grey literature and studies conducted only on allied health personnel were excluded from this review. Analysis:31 studies were included in this scoping review. Mindfulness practice was found to decrease emotional exhaustion and depersonalisation while improving mood, responses to stress, and vigour. Self-awareness, compassion, and empathy were also increased in study participants. From this review, four themes emerged which include: innovations in mindfulness practice, mindfulness and positive psychology, the impact of mindfulness on work and patient care, and barriers and facilitators to clinician mindfulness practice. Conclusion: Mindfulness had widely been reported to benefit mental health and well-being, but the studies reviewed seemed to adopt a mono focus and omitted key considerations to healthcare leadership, systems-level culture, and practices. Mindfulness practice is a quintessential component of positive psychology and is inherently linked to effective leadership. A mindful and compassionate clinician leader will play a crucial role in addressing gaps in current practice, prioritise staff mental health, and provide a supportive platform for innovation.

Keywords: mindfulness practice, clinician burnout, healthcare leadership, COVID-19

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Authors: Daniel Olshansky, Ramiro Rodrıguez Colmeiro

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Relay Mining presents a scalable solution employing probabilistic mechanisms and crypto-economic incentives to estimate RPC volume usage, facilitating decentralized multitenant rate limiting. Network traffic from individual applications can be concurrently serviced by multiple RPC service providers, with costs, rewards, and rate limiting governed by a native cryptocurrency on a distributed ledger. Building upon established research in token bucket algorithms and distributed rate-limiting penalty models, our approach harnesses a feedback loop control mechanism to adjust the difficulty of mining relay rewards, dynamically scaling with network usage growth. By leveraging crypto-economic incentives, we reduce coordination overhead costs and introduce a mechanism for providing RPC services that are both geopolitically and geographically distributed.

Keywords: remote procedure call, crypto-economic, commit-reveal, decentralization, scalability, blockchain, rate limiting, token bucket

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Authors: Hamed Saremi, Shahla Saremi

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In this study, control and management of construction projects is evaluated through developing a dynamic model in which some means are used in order to evaluating planning assumptions and reviewing the effectiveness of some project control policies based on previous researches about time, cost, project schedule pressure management, source management, project control, adding elements and sub-systems from cost management such as estimating consumption budget from budget due to costs, budget shortage effects and etc. using sensitivity analysis, researcher has evaluated introduced model that during model simulation by VENSIM software and assuming optimistic times and adding information about doing job and changes rate and project is forecasted with 373 days (2 days sooner than forecasted) and final profit $ 1,960,670 (23% amount of contract) assuming 15% inflation rate in year and costs rate accordance with planned amounts and other input information and final profit.

Keywords: dynamic planning, cost, time, performance, project management

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Authors: Miguel A. Orellana, Sonia E. Ruiz, Juan Bojórquez

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Optimal load factors (dead, live and seismic) used for the design of buildings may be different, depending of the seismic ground motion characteristics to which they are subjected, which are closely related to the type of soil conditions where the structures are located. The influence of the type of soil on those load factors, is analyzed in the present study. A methodology that is useful for establishing optimal load factors that minimize the cost over the life cycle of the structure is employed; and as a restriction, it is established that the probability of structural failure must be less than or equal to a prescribed value. The life-cycle cost model used here includes different types of costs. The optimization methodology is applied to two groups of reinforced concrete buildings. One set (consisting on 4-, 7-, and 10-story buildings) is located on firm ground (with a dominant period Ts=0.5 s) and the other (consisting on 6-, 12-, and 16-story buildings) on soft soil (Ts=1.5 s) of Mexico City. Each group of buildings is designed using different combinations of load factors. The statistics of the maximums inter-story drifts (associated with the structural capacity) are found by means of incremental dynamic analyses. The buildings located on firm zone are analyzed under the action of 10 strong seismic records, and those on soft zone, under 13 strong ground motions. All the motions correspond to seismic subduction events with magnitudes M=6.9. Then, the structural damage and the expected total costs, corresponding to each group of buildings, are estimated. It is concluded that the optimal load factors combination is different for the design of buildings located on firm ground than that for buildings located on soft soil.

Keywords: life-cycle cost, optimal load factors, reinforced concrete buildings, total costs, type of soil

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Authors: Nabiha Bouafia, Asma Ben Cheikh, Asma Ammar, Olfa Ezzi, Mohamed Mahjoub, Khaoula Meddeb, Imed Chouchene, Hamadi Boussarsar, Mansour Njah

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Background: Hospital acquired infections (HAI) cause significant morbidity, mortality, length of stay and hospital costs, especially in the intensive care unit (ICU), because of the debilitated immune systems of their patients and exposure to invasive devices. The aims of this study were to determine the rate and the risk factors of HAI in an ICU of a university hospital in Tunisia. Materials/Methods: A prospective study was conducted in the 8-bed adult medical ICU of a University Hospital (Sousse Tunisia) during 14 months from September 15th, 2015 to November 15th, 2016. Patients admitted for more than 48h were included. Their surveillance was stopped after the discharge from ICU or death. HAIs were defined according to standard Centers for Disease Control and Prevention criteria. Risk factors were analyzed by conditional stepwise logistic regression. The p-value of < 0.05 was considered significant. Results: During the study, 192 patients had admitted for more than 48 hours. Their mean age was 59.3± 18.20 years and 57.1% were male. Acute respiratory failure was the main reason of admission (72%). The mean SAPS II score calculated at admission was 32.5 ± 14 (range: 6 - 78). The exposure to the mechanical ventilation (MV) and the central venous catheter were observed in 169 (88 %) and 144 (75 %) patients, respectively. Seventy-three patients (38.02%) developed 94 HAIs. The incidence density of HAIs was 41.53 per 1000 patient day. Mortality rate in patients with HAIs was 65.8 %( n= 48). Regarding the type of infection, Ventilator Associated Pneumoniae (VAP) and central venous catheter Associated Infections (CVC AI) were the most frequent with Incidence density: 14.88/1000 days of MV for VAP and 20.02/1000 CVC days for CVC AI. There were 5 Peripheral Venous Catheter Associated Infections, 2 urinary tract infections, and 21 other HAIs. Gram-negative bacteria were the most common germs identified in HAIs: Multidrug resistant Acinetobacter Baumanii (45%) and Klebsiella pneumoniae (10.96%) were the most frequently isolated. Univariate analysis showed that transfer from another hospital department (p= 0.001), intubation (p < 10-4), tracheostomy (p < 10-4), age (p=0.028), grade of acute respiratory failure (p=0.01), duration of sedation (p < 10-4), number of CVC (p < 10-4), length of mechanical ventilation (p < 10-4) and length of stay (p < 10-4), were associated to high risk of HAIS in ICU. Multivariate analysis reveals that independent risk factors for HAIs are: transfer from another hospital department: OR=13.44, IC 95% [3.9, 44.2], p < 10-4, duration of sedation: OR= 1.18, IC 95% [1.049, 1.325], p=0.006, high number of CVC: OR=2.78, IC 95% [1.73, 4.487], p < 10-4, and length of stay in ICU: OR= 1.14, IC 95% [1.066,1.22], p < 10-4. Conclusion: Prevention of nosocomial infections in ICUs is a priority of health care systems all around the world. Yet, their control requires an understanding of epidemiological data collected in these units.

Keywords: healthcare associated infections, incidence, intensive care unit, risk factors

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Authors: Kateryna Zharan, Jan C. Bongaerts

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Mining operations are energy intensive, and the share of energy costs in total costs is often quoted in the range of 40 %. Saving on energy costs is, therefore, a key element of any mine operator. With the improving reliability and security of renewable energy (RE) sources, and requirements to reduce carbon dioxide emissions, perspectives for using RE in mining operations emerge. These aspects are stimulating the mining companies to search for ways to substitute fossil energy with RE. Hereby, the main purpose of this study is to present the survey research assessment in matter of finding out the key issues related to the integration of RE into mining activities, based on the mining and renewable energy experts’ opinion. The purpose of the paper is to present the outcomes of a survey conducted among mining and renewable energy experts about the feasibility of RE in mining operations. The survey research has been developed taking into consideration the following categories: first of all, the mining and renewable energy experts were chosen based on the specific criteria. Secondly, they were offered a questionnaire to gather their knowledge and opinions on incentives for mining operators to turn to RE, barriers and challenges to be expected, environmental effects, appropriate business models and the overall impact of RE on mining operations. The outcomes of the survey allow for the identification of factors which favor and disfavor decision-making on the use of RE in mining operations. It concludes with a set of recommendations for further study. One of them relates to a deeper analysis of benefits for mining operators when using RE, and another one suggests that appropriate business models considering economic and environmental issues need to be studied and developed. The results of the paper will be used for developing a hybrid optimized model which might be adopted at mines according to their operation processes as well as economic and environmental perspectives.

Keywords: carbon dioxide emissions, mining industry, photovoltaic, renewable energy, survey research, wind generation

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Authors: Ling-Lang Huang

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Research Background: Historically, the evolution of medicine has not only aimed to extend life but has also inadvertently introduced suffering in the process of maintaining life, presenting a contemporary challenge. We must carefully assess the conflict between the length of life and the quality of living. Evidence-Based Medicine (EBM) exists primarily to ensure the quality of cures. However, EBM alone does not fulfill our ultimate medical goals; we must also evaluate Value-Based Medicine (VBM) to find the best treatment for patients. Research Methodology: We can attempt to integrate EBM with VBM. Within the five steps of EBM, the first three steps (Ask—Acquire—Appraise) focus on the physical aspect of humans. However, in the fourth and fifth steps (Apply—Assess), the focus shifts from the physical to applying evidence-based treatment to the patient and assessing its effectiveness, considering a holistic approach to the individual. To consider VBM for patients, we can divide the process into three steps: The first step is "awareness," recognizing that each patient inhabits a different life-world and possesses unique differences. The second step is "integration," akin to the hermeneutic concept of the Fusion of Horizons. This means being aware of differences and also understanding the origins of these patient differences. The third step is "respect," which involves setting aside our adherence to medical objectivity and scientific rigor to respect the ultimate healthcare decisions made by individuals regarding their lives. Discussion and Conclusion: After completing these three steps of VBM, we can return to the fifth step of EBM: Assess. Our assessment can now transcend the physical treatment focus of the initial steps to align with a holistic care philosophy.

Keywords: shared decision-making, evidence-based medicine, values-based medicine, holistic healthcare

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Authors: Jagannath Koravadi, Archith Gupta

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In a world with constantly growing energy prices, and growing concerns about the global climate changes caused by increased energy consumption, it is becoming more and more essential to save energy wherever possible. Refrigeration systems are one of the major and bulk energy consuming systems now-a-days in industrial sectors, residential sectors and household environment. Refrigeration systems with considerable cooling requirements consume a large amount of electricity and thereby contribute greatly to the running costs. Therefore, a great deal of attention is being paid towards improvement of the performance of the refrigeration systems in this regard throughout the world. The Coefficient of Performance (COP) of a refrigeration system is used for determining the system's overall efficiency. The operating cost to the consumer and the overall environmental impact of a refrigeration system in turn depends on the COP or efficiency of the system. The COP of a refrigeration system should therefore be as high as possible. Slight modifications in the technical elements of the modern refrigeration systems have the potential to reduce the energy consumption, and improvements in simple operational practices with minimal expenses can have beneficial impact on COP of the system. Thus, the challenge is to determine the changes that can be made in a refrigeration system in order to improve its performance, reduce operating costs and power requirement, improve environmental outcomes, and achieve a higher COP. The opportunity here, and a better solution to this challenge, will be to incorporate modifications in conventional refrigeration systems for saving energy. Energy efficiency, in addition to improvement of COP, can deliver a range of savings such as reduced operation and maintenance costs, improved system reliability, improved safety, increased productivity, better matching of refrigeration load and equipment capacity, reduced resource consumption and greenhouse gas emissions, better working environment, and reduced energy costs. The present work aims at fabricating a working model of a refrigerator that will provide for effective heat recovery from superheated refrigerant with the help of an efficient de-superheater. The temperature of the refrigerant and water in the de-super heater at different intervals of time are measured to determine the quantity of waste heat recovered. It is found that the COP of the system improves by about 6% with the de-superheater and the power input to the compressor decreases by 4 % and also the refrigeration capacity increases by 4%.

Keywords: coefficiency of performance, de-superheater, refrigerant, refrigeration capacity, heat recovery

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Authors: Qiuxiao Chen, Yan Hou, Ning Wu

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As there are deficiencies of the classic Douglas-Peucker Algorithm (DPA), such as high risks of deleting key nodes by mistake, high complexity, time consumption and relatively slow execution speed, a new Deletion-Cost Based Compression Algorithm (DCA) for linear vector data was proposed. For each curve — the basic element of linear vector data, all the deletion costs of its middle nodes were calculated, and the minimum deletion cost was compared with the pre-defined threshold. If the former was greater than or equal to the latter, all remaining nodes were reserved and the curve’s compression process was finished. Otherwise, the node with the minimal deletion cost was deleted, its two neighbors' deletion costs were updated, and the same loop on the compressed curve was repeated till the termination. By several comparative experiments using different types of linear vector data, the comparison between DPA and DCA was performed from the aspects of compression quality and computing efficiency. Experiment results showed that DCA outperformed DPA in compression accuracy and execution efficiency as well.

Keywords: Douglas-Peucker algorithm, linear vector data, compression, deletion cost

Procedia PDF Downloads 224

Authors: Saeedeh Ahmadi Basir, Mohammad Mahdavi Mazdeh, Mohammad Namakshenas

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Manufacturers often dispatch jobs in batches to reduce delivery costs. However, sending several jobs in batches can have a negative effect on other scheduling-related objective functions such as minimizing the number of tardy jobs which is often used to rate managers’ performance in many manufacturing environments. This paper aims to minimize the number of weighted tardy jobs and the sum of delivery costs of a two-stage assembly flow-shop problem in a batch delivery system. We present a mixed-integer linear programming (MILP) model to solve the problem. As this is an MILP model, the commercial solver (the CPLEX solver) is not guaranteed to find the optimal solution for large-size problems at a reasonable amount of time. We present several numerical examples to confirm the accuracy of the model.

Keywords: scheduling, two-stage assembly flow-shop, tardy jobs, batched delivery system

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Authors: Georges Ghazi, Marc-Henry Devillers, Ruxandra M. Botez

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Aircraft flight trajectory optimization has been identified to be a promising solution for reducing both airline costs and the aviation net carbon footprint. Nowadays, this role has been mainly attributed to the flight management system. This system is an onboard multi-purpose computer responsible for providing the crew members with the optimized flight plan from a destination to the next. To accomplish this function, the flight management system uses a variety of look-up tables to compute the optimal speed and altitude for each flight regime instantly. Because the cruise is the longest segment of a typical flight, the proposed algorithm is focused on minimizing fuel consumption for this flight phase. In this paper, a complete methodology to estimate the aircraft performance and subsequently compute the optimal speed in cruise is presented. Results showed that the obtained performance database was accurate enough to predict the flight costs associated with the cruise phase.

Keywords: Cessna Citation X, cruise speed optimization, flight cost, cost index, and golden section search

Procedia PDF Downloads 270

Authors: Emily Hickmann, Peggy Richter, Maren Kaehlig, Hannes Schlieter

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Patient engagement is a cornerstone of high-quality care and essential for patients with chronic diseases to achieve improved health outcomes. Through digital transformation, possibilities to engage patients in their personal healthcare have multiplied. However, the exploitation of this potential is still lagging. To support the transmission of patient engagement theory into practice, this paper’s objective is to give a state-of-the-art overview of patient engagement tools and methods. A systematic literature review was conducted. Overall, 56 tools and methods were extracted and synthesized according to the four attributes of patient engagement, i.e., personalization, access, commitment, and therapeutic alliance. The results are discussed in terms of their potential to be implemented in digital health solutions under consideration of the “computers are social actors” (CASA) paradigm. It is concluded that digital health can catalyze patient engagement in practice, and a broad future research agenda is formulated.

Keywords: chronic diseases, digitalization, patient-centeredness, patient empowerment, patient engagement

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Authors: J. Stejskal, P. Hajek

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The goal of this article is the analysis of knowledge transfer at the regional level of the Czech Republic. We show how goals of enterprises´ innovative activities are related to the rate of cooperation with different actors within regional innovative systems as well as in other world regions. The results show that the most important partners of enterprises are their suppliers and clients in most Czech regions. The cooperation rate of enterprises correlates significantly mainly with enterprises´ efforts to enter new markets and reduce labour costs per unit output. The meaning of this cooperation decreases with the increase of partner’s distance. Regarding the type of a cooperating partner, cooperation within an enterprise had to do with the increase of market share and decrease of labour costs. On the other hand, cooperation with clients had to do with efforts to replace outdated products or processes or enter new markets. We can pay less attention to the cooperation with government authorities and organizations. The reasons for marginalization of this cooperation should be submitted to further detailed investigation.

Keywords: knowledge, transfer, innovative process, Czech republic, region

Procedia PDF Downloads 401