Search results for: failure costs

Authors: Tess Howard, Lily Owens, Maneesha De Silva, Russell Hodgson

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Purpose: This study aims to evaluate the cost-effectiveness of laparoscopic common bile duct exploration (CBDE) compared to endoscopic retrograde cholangiopancreatography (ERCP) and cholecystectomy for the emergency management of common bile duct (CBD) stones. Methodology: A retrospective case note review was conducted on consecutive patients undergoing emergency management of CBD stones using either CBDE, or ERCP and cholecystectomy at a single centre between January 2014-October 2014. Data on admission and procedural costs, length of hospital stay, postoperative complications and further stone related interventions were analysed. Results: A total of 350 patients were analysed. Among them, 299 patients underwent CBDE at the time of cholecystectomy, while the remaining 51 underwent ERCP either pre-, intra- or post cholecystectomy. CBDE was associated with lower overall costs compared to ERCP with an average hospital stay cost of $13,093 vs $22,930 respectively. This was largely attributed to shorter hospital stays (6.5 vs 10.3 days), decreased need for intensive care unit admission and fewer postoperative interventions within the CBDE group. Notably, single procedure laparoscopic cholecystectomy with CBDE demonstrated decreased operative costs compared to laparoscopic cholecystectomy combined with ERCP pre-/intra- or post-operatively ($3,747 vs. $4,641). Conclusion: Emergent CBDE is a cost-effective alternative to ERCP for managing CBD stones when combined with cholecystectomy. The upfront investment in equipment for CBDE and increased cholecystectomy procedural time is counterbalanced by reduced hospital stay, fewer procedures and subsequent cost savings. Economic considerations, in conjunction with clinical outcomes, should inform the selection of the optimal approach for CBD stone management in emergency settings.

Keywords: choledocolithiasis, management, cost-effectiveness, endoscopic retrograde cholangiopancreatography, ERCP, CBDE, common bile duct exploration

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Authors: Seyran Naghdi

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Background: Orphan drug development is limited by very high costs attributed to the research and development and small size market. How health policymakers address this challenge to consider both supply and demand sides need to be explored for directing the policies and plans in the right way. The price is an important signal for pharmaceutical companies’ profitability and the patients’ accessibility as well. Objective: This study aims to find out the orphan drugs' price-setting patterns and approaches in health systems through a systematic review of the available evidence. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) approach was used. MedLine, Embase, and Web of Sciences were searched via appropriate search strategies. Through Medical Subject Headings (MeSH), the appropriate terms for pricing were 'cost and cost analysis', and it was 'orphan drug production', and 'orphan drug', for orphan drugs. The critical appraisal was performed by the Joanna-Briggs tool. A Cochrane data extraction form was used to obtain the data about the studies' characteristics, results, and conclusions. Results: Totally, 1,197 records were found. It included 640 hits from Embase, 327 from Web of Sciences, and 230 MedLine. After removing the duplicates, 1,056 studies remained. Of them, 924 studies were removed in the primary screening phase. Of them, 26 studies were included for data extraction. The majority of the studies (>75%) are from developed countries, among them, approximately 80% of the studies are from European countries. Approximately 85% of evidence has been produced in the recent decade. Conclusions: There is a huge variation of price-setting among countries, and this is related to the specific pharmacological market structure and the thresholds that governments want to intervene in the process of pricing. On the other hand, there is some evidence on the availability of spaces to reduce the very high costs of orphan drugs development through an early agreement between pharmacological firms and governments. Further studies need to focus on how the governments could incentivize the companies to agree on providing the drugs at lower prices.

Keywords: orphan drugs, orphan drug production, pricing, costs, cost analysis

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Authors: Alexander Musyoki, Collins Odour

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Over the past few years, the bakery industry in Kenya has experienced significant growth largely in part to the increased adoption of technology and automation in their processes; more specifically due to the adoption of bakery management systems to help in running bakeries. While they have been largely responsible for the improved productivity and efficiency in bakeries, most of them are now outdated and pose more challenges than benefits. The proposed online bakery management system mentioned in this paper aims to address this by allowing bakery owners to track inventory, budget, job progress, and data analytics on each job and in doing so, promote the Sustainable Development Goals 3 and 12, which aim to ensure healthy lives and promote sustainable economic growth as the proposed benefits of these features include scalability, easy accessibility, reduced acquisition costs, better reliability, and improved functionality that will allow bakeries to become more competitive, reduce waste and track inventory more efficiently. To better understand the challenges, a comprehensive study has been performed to assess these traditional systems and try to understand if an online bakery management system can prove to be advantageous to bakery owners. The study conducted gathered feedback from bakery owners and employees in Nairobi County, Kenya using an online survey with a response rate of about 86% from the target population. The responses cited complex and hard to use bakery management systems (59.7%), lack of portability from one device to the other (58.1%) and high acquisition costs (51.6%) as the top challenges of traditional bakery management systems. On the other hand, some of the top benefits that most of the respondents would realize from the online bakery management system was better reliability (58.1%) and reduced acquisition costs (58.1%). Overall, the findings suggest that an online bakery management system has a lot of advantages over traditional systems and is likely to be well-received in the market. In conclusion, the proposed online bakery management system has the potential to improve the efficiency and competitiveness of small-sized bakeries in Nairobi County. Further research is recommended to expand the sample size and diversity of respondents and to conduct more in-depth analyses of the data collected.

Keywords: ICT, technology and automation, bakery management systems, food innovation

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Authors: Mathias Linden, André Schneider, Harald F. O. von Korflesch

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The risk of train accidents is an ongoing concern for railway organizations, governments, insurance companies and other depended sectors. Safety technologies are installed to reduce and to prevent potential damages of train accidents. Since the budgetary for the safety of railway organizations is limited, it is necessary not only to achieve a high availability and high safety standard but also to be cost effective. Therefore, an economic assessment of safety technologies is fundamental to create an accurate risk analysis. In order to conduct an economical assessment of a railway safety technology and a quantification of the costs of the accident causes, the Global Railway Accident Database & Evaluation (GRADE) has been developed. The aim of this paper is to describe the structure of this accident database and to show how it can be used for risk analyses. A number of risk analysis methods, such as the probabilistic safety assessment method (PSA), was used to demonstrate this accident database’s different possibilities of risk analysis. In conclusion, it can be noted that these analyses would not be as accurate without GRADE. The information gathered in the accident database was not available in this way before. Our findings are relevant for railway operators, safety technology suppliers, assurances, governments and other concerned railway organizations.

Keywords: accident causes, accident costs, accident database, global railway accident database & evaluation, GRADE, probabilistic safety assessment, PSA, railway accidents, risk analysis

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Authors: Tsafi Timor

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The research focuses on the exploration of the unique journey that novice teachers experience in their first year of teaching, among graduates of re-training programs into teaching. The study explores the experiences of success and failure and the factors that underpin positive experiences, as well as the journey (process) of this year with reference to the comparison between novice teachers and new immigrants. The content analysis that was adopted in the study was conducted on texts that were written by the teachers and detailed their first year of teaching. The findings indicate that experiences of success are featured by personal satisfaction, constant need of feedback, high motivation in challenging situations, and emotions. Failure experiences are featured by frustration, helplessness, sense of humiliation, feeling of rejection, and lack of efficacy. Factors that promote and inhibit positive experiences relate to personal, personality, professional and organizational levels. Most teachers reported feeling like new immigrants, and demonstrated different models of the process of the first year of teaching. Further research is recommended on the factors that promote and inhibit positive experiences, and on 'The Missing Link' of the relationship between Teacher Education Programs and the practices in schools.

Keywords: first-year teaching, novice teachers, school practice, teacher education programs

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Authors: Minsung Kim, Hyunkoo Kang, Jinkoo Kim

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In this study, a hybrid energy dissipation device is developed by combining a steel slit plate and friction pads to be used for seismic retrofit of structures, and its effectiveness is investigated by comparing the life cycle costs of the structure before and after the retrofit. The seismic energy dissipation capability of the dampers is confirmed by cyclic loading tests. The probabilities of reaching various damage states are obtained by fragility analysis, and the life cycle costs of the model structures are computed using the PACT (Performance Assessment Calculation Tool) program based on FEMA P-58 methodology. The fragility analysis shows that the probabilities of reaching limit states are minimized by the seismic retrofit with hybrid dampers and increasing column size. The seismic retrofit with increasing column size and hybrid dampers results in the lowest repair cost and shortest repair time. This research was supported by a grant (13AUDP-B066083-01) from Architecture & Urban Development Research Program funded by Ministry of Land, Infrastructure and Transport of Korean government.

Keywords: FEMA P-58, friction dampers, life cycle cost, seismic retrofit

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Authors: Shima Taheri, Simon Clark

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Concrete is an essential building material used in the majority of structures. Degradation of concrete over time increases the life-cycle cost of an asset with an estimated annual cost of billions of dollars to national economies. Most of the concrete failure occurs due to cracks, which propagate through a structure and cause weakening leading to failure. Stopping crack propagation is thus the key to protecting concrete structures from failure and is the best way to prevent inconveniences and catastrophes. Furthermore, the majority of cracks occur deep within the concrete in inaccessible areas and are invisible to normal inspection. Few materials intrinsically possess self-healing ability, but one that does is concrete. However, self-healing in concrete is limited to small dormant cracks in a moist environment and is difficult to control. In this project, we developed a method for self-healing of nascent fractures in concrete components through the automatic release of self-curing healing agents encapsulated in breakable nano- and micro-structures. The Poly(methyl methacrylate) (PMMA) based two-part adhesive is encapsulated in core-shell structures with brittle/weak inert shell, synthesized via miniemulsion/solvent evaporation polymerization. Stress fields associated with propagating cracks can break these capsules releasing the healing agents at the point where they are needed. The shell thickness is playing an important role in preserving the content until the final setting of concrete. The capsules can also be surface functionalized with carboxyl groups to overcome the homogenous mixing issues. Currently, this formulated self-healing system can replace up to 1% of cement in a concrete formulation. Increasing this amount to 5-7% in the concrete formulation without compromising compression strength and shrinkage properties, is still under investigation. This self-healing system will not only increase the durability of structures by stopping crack propagation but also allow the use of less cement in concrete construction, thereby adding to the global effort for CO2 emission reduction.

Keywords: self-healing concrete, concrete crack, concrete deterioration, durability

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Authors: Motaz Alsolaim

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Nowadays, the challenges of running a start-up can be very complex and are perhaps more difficult than at any other time in the past. Changes in technology, manufacturing innovation, and product development, combined with intense competition and market regulations are factors that have put pressure on classic ways of managing firms, thereby forcing change. As a result, the rate of closure, exit or discontinuation of start-ups and young businesses is very high. Despite the essential role of small firms in an economy, they still tend to face obstacles that exert a negative influence on their performance and rate of survival. In fact, it is not easy to determine with any certainty the reasons why small firms fail. For this reason, failure itself is not clearly defined, and its exact causes are hard to diagnose. In this current study, therefore, the barriers to survival will be covered more broadly, especially personal/entrepreneurial, enterprise and environmental factors with regard to various possible reasons for this failure, in order to determine the best solutions and make appropriate recommendations. Methodology: It could be argued that mixed methods might help to improve entrepreneurship research addressing challenges emphasis in previous studies and to achieve the triangulation. Calls for the combined use of quantitative and qualitative research were also made in the entrepreneurship field since entrepreneurship is a multi-faceted area of research. Therefore, explanatory sequential mixed method was used, using questionnaire online survey for entrepreneurs, followed by semi-structure interview. Collecting over 750 surveys and accepting 296 valid surveys, after that 13 interviews from government official seniors, businessmen successful entrepreneurs, and non-successful entrepreneurs. Findings: The first phase findings ( quantitative) shows the obstacles to survive; starting from the personal/ entrepreneurial factors such as; past work experience, lack of skills and interest, are positive factors, while; gender, age and education level of the owner are negative factors. Internal factors such as lack of marketing research and weak business planning are positive. The environmental factors; in economic perspectives; difficulty to find labors, in socio-cultural perspectives; Social restriction and traditions found to be a negative factors. In other hand, from the political perspective; cost of compliance and insufficient government plans found to be a positive factors for small business failure. From infrastructure perspective; lack of skills labor, high level of bureaucracy and lack of information are positive factors. Conclusion: This paper serves to enrich the understanding of failure factors in MENA region more precisely in SA, by minimizing the probability of failure in small-micro entrepreneurial start-up in SA, in the light of the Saudi government’s Vision 2030 plan.

Keywords: small business barriers, start-up business, entrepreneurship, Saudi Arabia

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Authors: Panarat Saengpanya

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There were five objectives in this study including the study of housing type with water environment, the physical and mechanical properties of the buoy material, the mechanical properties of the buoy models, the floating of the buoy models and the relationship between the civil engineering parameters and the floating of the buoy. The buoy examples made from Expanded Polystyrene (EPS) covered by 5 mm thickness of mortar with the equal thickness on each side. Specimens are 0.05 m cubes tested at a displacement rate of 0.005 m/min. The existing test method used to assess the parameters relationship is ASTM C 109 to provide comparative results. The results found that the three type of housing with water environment were Stilt Houses, Boat House, and Floating House. EPS is a lightweight material that has been used in engineering applications since at least the 1950s. Its density is about a hundredth of that of mortar, while the mortar strength was found 72 times of EPS. One of the advantage of composite is that two or more materials could be combined to take advantage of the good characteristics of each of the material. The strength of the buoy influenced by mortar while the floating influenced by EPS. Results showed the buoy example compressed under loading. The Stress-Strain curve showed the high secant modulus before reached the peak value. The failure occurred within 10% strain then the strength reduces while the strain was continuing. It was observed that the failure strength reduced by increasing the total volume of examples. For the buoy examples with same area, an increase of the failure strength is found when the high dimension is increased. The results showed the relationship between five parameters including the floating level, the bearing capacity, the volume, the high dimension and the unit weight. The study found increases in high of buoy lead to corresponding decreases in both modulus and compressive strength. The total volume and the unit weight had relationship with the bearing capacity of the buoy.

Keywords: floating house, buoy, floating structure, EPS

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Authors: Nantakrit Yodpijit, Teppakorn Sittiwanchai

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The number of older adults is rising rapidly. The world’s population becomes aging. Falls is one of common and major health problems in the elderly. Falls may lead to acute and chronic injuries and deaths. The fall-prone individuals are at greater risk for decreased quality of life, lowered productivity and poverty, social problems, and additional health problems. A number of studies on falls prevention using fall detection system have been conducted. Many available technologies for fall detection system are laboratory-based and can incur substantial costs for falls prevention. The utilization of alternative technologies can potentially reduce costs. This paper presents the new design and development of a wearable-based fall detection system using an Accelerometer and Gyroscope as motion sensors for the detection of body orientation and movement. Algorithms are developed to differentiate between Activities of Daily Living (ADL) and falls by comparing Threshold-based values with Artificial Neural Networks (ANN). Results indicate the possibility of using the new threshold-based method with neural network algorithm to reduce the number of false positive (false alarm) and improve the accuracy of fall detection system.

Keywords: aging, algorithm, artificial neural networks (ANN), fall detection system, motion sensorsthreshold

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Authors: Ana Neves, John Leander, Ignacio Gonzalez, Raid Karoumi

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Systematic monitoring and inspection are needed to assess the present state of a structure and predict its future condition. If an irregularity is noticed, repair actions may take place and the adequate intervention will most probably reduce the future costs with maintenance, minimize downtime and increase safety by avoiding the failure of the structure as a whole or of one of its structural parts. For this to be possible decisions must be made at the right time, which implies using systems that can detect abnormalities in their early stage. In this sense, Structural Health Monitoring (SHM) is seen as an effective tool for improving the safety and reliability of infrastructures. This paper explores the decision-making problem in SHM regarding the maintenance of civil engineering structures. The aim is to assess the present condition of a bridge based exclusively on measurements using the suggested method in this paper, such that action is taken coherently with the information made available by the monitoring system. Artificial Neural Networks are trained and their ability to predict structural behavior is evaluated in the light of a case study where acceleration measurements are acquired from a bridge located in Stockholm, Sweden. This relatively old bridge is presently still in operation despite experiencing obvious problems already reported in previous inspections. The prediction errors provide a measure of the accuracy of the algorithm and are subjected to further investigation, which comprises concepts like clustering analysis and statistical hypothesis testing. These enable to interpret the obtained prediction errors, draw conclusions about the state of the structure and thus support decision making regarding its maintenance.

Keywords: artificial neural networks, clustering analysis, model-free damage detection, statistical hypothesis testing, structural health monitoring

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Authors: Ralene Sim, Stefan Mueller, N. Gopalakrishna Iyer, Ngian Chye Tan, Khee Chee Soo, R. Shetty Mahalakshmi, Hiang Khoon Tan

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Background: Regional failure in nasopharyngeal carcinoma (NPC) is managed by salvage treatment in the form of neck dissection. Radical neck dissection (RND) is preferred over modified radical neck dissection (MRND) since it is traditionally believed to offer better long-term disease control. However, with the advent of more advanced imaging modalities like high-resolution Magnetic Resonance Imaging, Computed Tomography, and Positron Emission Tomography-CT scans, earlier detection is achieved. Additionally, concurrent chemotherapy also contributes to reduced tumour burden. Hence, there may be a lesser need for an RND and a greater role for MRND. With this retrospective study, the primary aim is to ascertain whether MRND, as opposed to RND, has similar outcomes and hence, whether there would be more grounds to offer a less aggressive procedure to achieve lower patient morbidity. Methods: This is a retrospective study of 66 NPC patients treated at Singapore General Hospital between 1994 to 2016 for histologically proven regional recurrence, of which 41 patients underwent RND and 25 who underwent MRND, based on surgeon preference. The type of ND performed, primary treatment mode, adjuvant treatment, and pattern of recurrence were reviewed. Overall survival (OS) was calculated using Kaplan-Meier estimate and compared. Results: Overall, the disease parameters such as nodal involvement and extranodal extension were comparable between the two groups. Comparing MRND and RND, the median (IQR) OS is 1.76 (0.58 to 3.49) and 2.41 (0.78 to 4.11) respectively. However, the p-value found is 0.5301 and hence not statistically significant. Conclusion: RND is more aggressive and has been associated with greater morbidity. Hence, with similar outcomes, MRND could be an alternative salvage procedure for regional failure in selected NPC patients, allowing similar salvage rates with lesser mortality and morbidity.

Keywords: nasopharyngeal carcinoma, neck dissection, modified neck dissection, radical neck dissection

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Authors: Antoaneta Stefanova, Rositsa Gencheva, Pavlin Groudev

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This paper presents the modeling approach in SBO sequence for VVER 1000 reactors and describes the reactor core behavior at late in-vessel phase in case of late reflooding by HPIS and gives preliminary results for the ASTECv2 validation. The work is focused on investigation of plant behavior during total loss of power and the operator actions. The main goal of these analyses is to assess the phenomena arising during the Station blackout (SBO) followed by primary side high pressure injection system (HPIS) reflooding of already damaged reactor core at very late ‘in-vessel’ phase. The purpose of the analysis is to define how the later HPIS switching on can delay the time of vessel failure or possibly avoid vessel failure. For this purpose has been simulated an SBO scenario with injection of cold water by a high pressure pump (HPP) in cold leg at different stages of core degradation. The times for HPP injection were chosen based on previously performed investigations.

Keywords: VVER, operator action validation, reflooding of overheated reactor core, ASTEC computer code

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Authors: Ayeshmanthe Rathnayake, Siew Goh, Carmel Fenton, Ashutosh Hardikar

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Post-Operative Atrial Fibrillation (POAF) is the most frequent complication of cardiac surgery and is associated with reduced survival, increased rates of cognitive changes and cerebrovascular accident, heart failure, renal dysfunction, infection and length of stay, and hospital costs. Cardiac tamponade, although less common, carries high morbidity and mortality. Shed mediastinal blood in the pericardial space is a major source of intrapericardial oxidative stress and inflammation that triggers POAF. The utilisation of a left posterior pericardiotomy aims to shunt blood from the pericardium into the pleural space and have a role in the prevention of POAF as well as cardiac tamponade. 2118 patients had undergone isolated Coronary Artery Bypass Graft (CABG) at Royal Hobart Hospital from 2008-2021. They were divided into pericardiotomy vs control group. Patient baseline demographics, intraoperative data, and post-operative outcomes were reviewed retrospectively. Total incidence of new POAF and cardiac tamponade was 26.1% and 0.75%, respectively. Primary outcome of both the incidence of POAF(22.9% vs27.8%OR 0.77 p<0.05) and Cardiac Tamponade (0% vs 1.1% OR 0.85 p<0.05) were less in the pericardiotomy group.Increasing age, BMI, poor left ventricular function (EF <30%), and return to theatre were independent predictors of developing POAF. There were similar rates of return to theatre for bleeding however, no cases of tamponade in the pericardiotomy group. There were no complications attributable to left posterior pericardiotomy and the time added to the duration of surgery was minimal. Left posterior pericardiotomy is associated with a significant reduction in the incidence of POAFand cardiac tamponade and issafe and efficient.

Keywords: cardiac surgery, pericardiotomy, post-operative atrial fibrillation, cardiac tamponade

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Authors: Paul Han, Jun-Geol Baek

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In the flat panel display industry, the scheduler and dispatching system to meet production target quantities and the deadline of production are the major production management system which controls each facility production order and distribution of WIP (Work in Process). In dispatching system, delivery time is a key factor for the time when a lot can be supplied to the facility. In this paper, we use survival analysis methods to identify main factors and a forecasting model of delivery time. Of survival analysis techniques to select important explanatory variables, the cox proportional hazard model is used to. To make a prediction model, the Accelerated Failure Time (AFT) model was used. Performance comparisons were conducted with two other models, which are the technical statistics model based on transfer history and the linear regression model using same explanatory variables with AFT model. As a result, the Mean Square Error (MSE) criteria, the AFT model decreased by 33.8% compared to the existing prediction model, decreased by 5.3% compared to the linear regression model. This survival analysis approach is applicable to implementing a delivery time estimator in display manufacturing. And it can contribute to improve the productivity and reliability of production management system.

Keywords: delivery time, survival analysis, Cox PH model, accelerated failure time model

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Authors: C. M. Cebola, V. H. Ferreira

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In the past decade mediation has been legally implemented in European legal systems, especially after the publication by the European Union of the Directive 2008/52/EC on certain aspects of mediation in civil and mercantile matters. Developments in international trade and globalization in this new century have led to an increase of the number of litigations, often cross-border, and the courts have failed to respond adequately. We do not advocate that mediation should be promoted as the solution for all justice problems, but as a means with its own specificities that the parties may choose to consider as the best way to resolve their disputes. Thus, the implementation of mediation should be based on the advantages of its application. From the economic point of view, competitive negotiation can generate negative external effects in social terms. A solution reached in a court of law is not always the most efficient one considering all elements of society (economic social benefit). On the other hand, the administration of justice adds in economic terms transaction costs that can be mitigated by the application of other forms of conflict resolution, such as mediation. In this paper, the economic benefits of mediation will be analysed in the light of various studies on the functioning of justice. Several theoretical arguments will be confronted with empirical studies to demonstrate that mediation has significant positive economic effects. The objective is to contribute to the dissemination of mediation between companies and citizens, but also to demonstrate the cost to governments and states of still limited use of mediation, particularly in the current economic crisis and propose actions to develop the application of mediation.

Keywords: economic impact, litigation costs, mediation, solutions

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Authors: Reyhaneh Soltanshah, Hamid R. Zarandi

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In order to be more efficient in industries that are related to computer systems, software testing is necessary despite spending time and money. In the embedded system software test, complete knowledge of the embedded system architecture is necessary to avoid significant costs and damages. Software tests increase the price of the final product. The aim of this article is to provide a method to reduce time and cost in tests based on program structure. First, a complete review of eleven white box test methods based on ISO/IEC/IEEE 29119 2015 and 2021 versions has been done. The proposed algorithm is designed using two versions of the 29119 standards, and some white-box testing methods that are expensive or have little coverage have been removed. On each of the functions, white box test methods were applied according to the 29119 standard and then the proposed algorithm was implemented on the functions. To speed up the implementation of the proposed method, the Unity framework has been used with some changes. Unity framework can be used in embedded software testing due to its open source and ability to implement white box test methods. The test items obtained from these two approaches were evaluated using a mathematical ratio, which in various software mining reduced between 50% and 80% of the test cost and reached the desired result with the minimum number of test items.

Keywords: embedded software, reduce costs, software testing, white-box testing

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Authors: Maria Amaia Iza Padilla, Ibai Ostolozaga

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The objective of this paper is to analyze how transportation costs between regions within a country can affect not only domestic trade but also the allocation of resources in a given region, aggregate productivity, and relative domestic prices (tradable versus non-tradable). On the one hand, there is a vast literature that analyzes the transportation costs faced by countries when trading with the rest of the world. However, this paper focuses on the effect of transportation costs on domestic trade. Countries differ in their domestic road infrastructure and transport quality. There is also some literature that focuses on the effect of road infrastructure on the price difference between regions but not on relative prices at the aggregate level. On the other hand, this work is also related to the literature on resource misallocation. Finally, the paper is also related to the literature analyzing the effect of trade on the development of the manufacturing sector. Using the World Bank Enterprise Survey database, it is observed cross-country differences in the proportion of firms that consider transportation as an obstacle. From the International Comparison Program, we obtain a significant negative correlation between GDP per worker and relative prices (manufacturing sector prices relative to the service sector). Furthermore, there is a significant negative correlation between a country’s transportation quality and the relative price of manufactured goods with respect to the price of services in that country. This is consistent with the empirical evidence of a negative correlation between transportation quality and GDP per worker, on the one hand, and the negative correlation between GDP per worker and domestic relative prices, on the other. It is also shown that in a country, the share of manufacturing firms whose main market is at the local (regional) level is negatively related to the quality of the transportation infrastructure within the country. Similarly, this index is positively related to the share of manufacturing firms whose main market is national or international. The data also shows that those countries with a higher proportion of manufacturing firms operating locally have higher relative prices. With this information in hand, the paper attempts to quantify the effects of the allocation of resources between and within sectors. The higher the trade barriers caused by transportation costs, the less efficient allocation, which causes lower aggregate productivity. Second, it is built a two-sector model where regions within a country trade with each other. On the one hand, it is found that with respect to the manufacturing sector, those countries with less trade between their regions will be characterized by a smaller variety of goods, less productive manufacturing firms on average, and higher relative prices for manufactured goods relative to service sector prices. Thus, the decline in the relative price of manufactured goods in more advanced countries could also be explained by the degree of trade between regions. This trade allows for efficient intra-industry allocation (traders are more productive, and resources are allocated more efficiently)).

Keywords: misallocation, relative prices, TFP, transportation cost

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Authors: Khaled Darwish, Islam El Madahh, Hoda Mohamed, Hadia El Hennawy

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Cloud computing has been one of the fastest growing parts in IT industry mainly in the context of the future of the web where computing, communication, and storage services are main services provided for Internet users. Mobile Cloud Computing (MCC) is gaining stream which can be used to extend cloud computing functions, services and results to the world of future mobile applications and enables delivery of a large variety of cloud application to billions of smartphones and wearable devices. This paper describes reliability for MCC by determining the ability of a system or component to function correctly under stated conditions for a specified period of time to be able to deal with the estimation and management of high levels of lifetime engineering uncertainty and risks of failure. The assessment procedures consists of determine Mean Time between Failures (MTBF), Mean Time to Failure (MTTF), and availability percentages for main components in both cloud computing and MCC structures applied on single node OpenStack installation to analyze its performance with different settings governing the behavior of participants. Additionally, we presented several factors have a significant impact on rates of change overall cloud system reliability should be taken into account in order to deliver highly available cloud computing services for mobile consumers.

Keywords: cloud computing, mobile cloud computing, reliability, availability, OpenStack

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Authors: Madhavi-Priya Singh, Liam Lowe, Farouk Arnaout, Ludmilla Pillay, Giordan Perez, Luke Mischker, Steve Costa

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An Emergency Department consultant identified the failure of medical students to complete the task of clerking a patient in its entirety. As six medical students on our first clinical placement, we recognised our own failure and endeavoured to examine why this failure was consistent among all medical students that had been given this task, despite our best motivations as adult learner. Our aim is to understand and investigate the elements which impeded our ability to learn and perform as medical students in the clinical environment, with reference to the prescribed task. We also aim to generate a discussion around the delivery of medical education with potential solutions to these barriers. Six medical students gathered together to have a comprehensive reflective discussion to identify possible factors leading to the failure of the task. First, we thoroughly analysed the delivery of the instructions with reference to the literature to identify potential flaws. We then examined personal, social, ethical, and cultural factors which may have impacted our ability to complete the task in its entirety. Through collation of our shared experiences, with support from discussion in the field of medical education and ethics, we identified two major areas that impacted our ability to complete the set task. First, we experienced an ethical conflict where we believed the inconvenience and potential harm inflicted on patients did not justify the positive impact the patient interaction would have on our medical learning. Second, we identified a lack of confidence stemming from multiple factors, including the conflict between preclinical and clinical learning, perceptions of perfectionism in the culture of medicine, and the influence of upward social comparison. After discussions, we found that the various factors we identified exacerbated the fears and doubts we already had about our own abilities and that of the medical education system. This doubt led us to avoid completing certain aspects of the tasks that were prescribed and further reinforced our vulnerability and perceived incompetence. Exploration of philosophical theories identified the importance of the role of doubt in education. We propose the need for further discussion around incorporating both pedagogic and andragogic teaching styles in clinical medical education and the acceptance of doubt as a driver of our learning. Doubt will continue to permeate our thoughts and actions no matter what. The moral or psychological distress that arises from this is the key motivating factor for our avoidance of tasks. If we accept this doubt and education embraces this doubt, it will no longer linger in the shadows as a negative and restrictive emotion but fuel a brighter dialogue and positive learning experience, ultimately assisting us in achieving our full potential.

Keywords: medical education, clinical education, andragogy, pedagogy

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Authors: Asiye Aydilek, Harun Aydilek

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We investigate the costs of various suboptimal allocations in housing, consumption, bond and stock holdings of a retiree in a setting with recursive utility, considering the extensive empirical evidence that investors make suboptimal decisions in different ways. We find that suboptimal stock holdings impose only modest costs on the retiree. This may have a merit in explaining the limited stock investment in the data. The cost of suboptimal bond holdings is higher than that of stocks, but still small. This may partially explain why many more people hold bonds compared to stocks. We find that positive deviations from the optimal level are less costly relative to the negative ones in suboptimal housing allocations. This may help us to clarify why the elderly are over consuming housing, as seen in the housing data. The cost of suboptimal consumption is quite high and the highest of all. Our paper suggests that, in terms of welfare, the decisions of how much of liquid wealth to use for consumption and for saving are more important than the decision about the composition of liquid savings. Suboptimal stock holdings are twice more costly in power utility and suboptimal bond holdings are twenty times more costly in recursive utility. Recursive utility is superior to power utility in terms of rationalizing many people's preference for bonds instead of stocks in investment.

Keywords: housing, recursive utility, retirement, suboptimal decisions, welfare cost

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Authors: Hernán A. Perez, Luis J. Armando, Néstor H. García

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Background and aims Cardiovascular disease rates are very high in patients with renal failure (CRF), but the underlying mechanisms are incompletely understood. Traditional cardiovascular risk factors do not explain the increased risk, and observational studies have observed paradoxical or absent associations between classical risk factors and mortality in dialysis patients. A large randomized controlled trial, the 4D Study, the AURORA and the ALERT study found that statin therapy in CRF do not reduce cardiovascular events. These results may be the results of ‘accelerated atherosclerosis’ observed on these patients. The objective of this study was to investigate if carotid total plaque area (TPA), a measure of carotid plaque burden growth is increased at progressively lower creatinine clearance in patients with CRF. We studied a cohort of patients with CRF not on dialysis, reasoning that risk factor associations might be more easily discerned before end stage renal disease. Methods: The Blossom DMO Argentina ethics committee approved the study and informed consent from each participant was obtained. We performed a cohort study in 412 patients with Stage 1, 2 and 3 CRF. Clinical and laboratory data were obtained. TPA was determined using bilateral carotid ultrasonography. Modification of Diet in Renal Disease estimation formula was used to determine renal function. ANOVA was used when appropriate. Results: Stage 1 CRF group (n= 16, 43±2yo) had a blood pressure of 123±2/78±2 mmHg, BMI 30±1, LDL col 145±10 mg/dl, HbA1c 5.8±0.4% and had the lowest TPA 25.8±6.9 mm2. Stage 2 CRF (n=231, 50±1 yo) had a blood pressure of 132±1/81±1 mmHg, LDL col 125±2 mg/dl, HbA1c 6±0.1% and TPA 48±10mm2 ( p< 0.05 vs CRF stage 1) while Stage 3 CRF (n=165, 59±1 yo) had a blood pressure of 134±1/81±1, LDL col 125±3 mg/dl, HbA1c 6±0.1% and TPA 71±6mm2 (p < 0.05 vs CRF stage 1 and 2). Conclusion: Our data indicate that TPA increases along the renal function deterioration, and it is not related with the LDL cholesterol and triglycerides levels. We suggest that mechanisms other than the classics are responsible for the observed excess of cardiovascular disease in CKD patients and finally, determination of total plaque area should be used to measure effects of antiatherosclerotic therapy.

Keywords: hypertension, chronic renal failure, atherosclerosis, cholesterol

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Authors: M. Ali, K. Alam, E. Ohioma

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This paper presents a numerical investigation on the behavior of fiber reinforced polymer composite tubes (FRP) under thermomechanical coupled loading using finite element software ABAQUS and a special add-on subroutine, CZone. Three cases were explored; pure mechanical loading, pure thermal loading, and coupled thermomechanical loading. The failure index (Tsai-Wu) under all three loading cases was assessed for all plies in the tube walls. The simulation results under pure mechanical loading showed that composite tube failed at a tensile load of 3.1 kN. However, with the superposition of thermal load on mechanical load on the composite tube, the failure index of the previously failed plies in tube walls reduced significantly causing the tube to fail at 6 kN. This showed 93% improvement in the load carrying capacity of the composite tube in present study. The increase in load carrying capacity was attributed to the stress effects of the coefficients of thermal expansion (CTE) on the laminate as well as the inter-lamina stresses induced due to the composite stack layup.

Keywords: thermal, mechanical, composites, square tubes

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Authors: Mohanad Alhabo, Naveed Nawaz

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The ongoing call or data session must be maintained to ensure a good quality of service. This can be accomplished by performing the handover procedure while the user is on the move. However, the dense deployment of small cells in 5G networks is a challenging issue due to the extensive number of handovers. In this paper, a neighbour cell list method is proposed to reduce the number of target small cells and hence minimizing the number of handovers. The neighbour cell list is built by omitting cells that could cause an unnecessary handover and handover failure because of short time of stay of the user in these cells. A multi-attribute decision making technique, simple additive weighting, is then applied to the optimized neighbour cell list. Multi-tier small cells network is considered in this work. The performance of the proposed method is analysed and compared with that of the existing methods. Results disclose that our method has decreased the candidate small cell list, unnecessary handovers, handover failure, and short time of stay cells compared to the competitive method.

Keywords: handover, HetNets, multi-attribute decision making, small cells

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Authors: Chiung-Yao Huang, Yu-Cheng Lin, Chiung-Hui Chen

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This study seeks to examine perceived environmental corporate social responsibility (ECSR) with a focus on negative environmental questions, related to intention of ethical investment intention after a environmental failure recovery. An empirical test was employed to test the hypotheses. We manipulated the information on negative ECSR activities of a hypothetical firm in a experimental design with a failure recovery treatment. The company’s negative ECSR recovery was depicted in a positive perspective (depicting a follow-up strong social action), whereas in the negative ECSR treatment it was described in a negative perspective (depicting a follow-up non social action). In both treatments, information about other key characteristics of the focal company were kept constant. Investors’ intentions to invest in the company’s stock were evaluated by multi-item scales. Results indicate that positive ECSR recovery information about a firm enhances investors’ intentions to invest in the company’s stock. In addition, perceived moral intensity has a significant impact on the intention of ethical investment and that perceived moral intensity also serves as a key moderating variable in the relationship between negative ECSR and the intention of ethical investment. Finally, theoretical and managerial implications of the findings are discussed. Practical implications: The results suggest that managers may need to be aware of perceived moral intensity as a key variable in restoring the intention of ethical investment. The results further suggest that perceived moral intensity has a direct, and it also has an moderating influence between ECSR and the intention of ethical investment. Originality/value: In an attempt to deepen the understanding of how investors perceptions of firm environmental CSR are connected with other investor‐related outcomes through ECSR recovery, the present research proposes a comprehensive model which encompasses ECSR and other key relationship constructs after a ECSR failure and recovery.

Keywords: ethical investment, Environmental Corporate Social Responsibility(ECSR), ECSR recovery, moral intensity

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Authors: Anil Khanal, Ali Osareh, Gary Lebby

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Wind energy offers a significant advantage such as no fuel costs and no emissions from generation. However, wind energy sources are variable and non-dispatchable. The utility grid is able to accommodate the variability of wind in smaller proportion along with the daily load. However, at high penetration levels, the variability can severely impact the utility reserve requirements and the cost associated with it. In this paper, the impact of wind energy is evaluated in detail in formulating the total utility cost. The objective is to minimize the overall cost of generation while ensuring the proper management of the load. Overall cost includes the curtailment cost, reserve cost and the reliability cost as well as any other penalty imposed by the regulatory authority. Different levels of wind penetrations are explored and the cost impacts are evaluated. As the penetration level increases significantly, the reliability becomes a critical question to be answered. Here, we increase the penetration from the wind yet keep the reliability factor within the acceptable limit provided by NERC. This paper uses an economic dispatch (ED) model to incorporate wind generation into the power grid. Power system costs are analyzed at various wind penetration levels using Linear Programming. The goal of this study shows how the increases in wind generation will affect power system economics.

Keywords: wind power generation, wind power penetration, cost analysis, economic dispatch (ED) model

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Authors: Sumanta Das, Miroslav Gašparík, Tomáš Kytka, Anil Kumar Sethy

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In this modern century, Cross-laminated timber (CLT) evolved as an excellent material for building and high load-bearing structural applications worldwide. CLT is produced mainly from softwoods such as Norway spruce, White fir, Scots pine, European larch, Douglas fir, and Swiss stone pine. The use of hardwoods in CLT production is still at an early stage, and the utilization of hardwoods is expected to provide the opportunity for obtaining higher bending stiffness and shear resistance to CLT panels. In load-bearing structures like CLT, bonding is an important character that is needed to evaluate. One particular issue with using hardwood lumber in CLT panels is that it is often more challenging to achieve a strong, durable adhesive bond. Several researches in the past years have already evaluated the bonding properties of CLT panels from hardwood both from higher and lower densities. This research aims to identify the effect of pressure and glue spread and evaluate which poplar lumber characteristics affect adhesive bond quality. Three-layered CLT panels were prepared from poplar wood with one-component polyurethane (PUR) adhesive by applying pressure of 0.6 N/mm2 and 1 N/mm2 with a glue spread rate of 160 and 180 g/m2. The delamination and block shear tests were carried out as per EN 16351:2015, and the wood failure percentage was also evaluated. The results revealed that glue spread rate and applied pressure significantly influenced both the shear bond strength and wood failure percentage of the CLT. However, samples with lower pressure 0.6 N/mm2 and less glue spread rate showed delamination, and in samples with higher pressure 1 N/mm2 and higher glue spread rate, no delamination was observed. All the properties determined by this study met the minimum requirement mentioned in EN 16351:2015 standard.

Keywords: cross-laminated timber, delamination, glue spread rate, poplar, pressure, PUR, shear strength, wood failure percentage

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Authors: Tiberiu Socaciu, Tudor Colomeischi, Eugenia Iancu

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Business failure affects in various proportions shareholders, managers, lenders (banks), suppliers, customers, the financial community, government and society as a whole. In the era in which we have telecommunications networks, exists an interdependence of markets, the effect of a failure of a company is relatively instant. To effectively manage risk exposure is thus require sophisticated support systems, supported by analytical tools to measure, monitor, manage and control operational risks that may arise. As we know, bankruptcy is a phenomenon that managers do not want no matter what stage of life is the company they direct / lead. In the analysis made by us, by the nature of economic models that are reviewed (Altman, Conan-Holder etc.), estimating the risk of bankruptcy of a company corresponds to some extent with its own business cycle tracing of the company. Various models for predicting bankruptcy take into account direct / indirect aspects such as market position, company growth trend, competition structure, characteristics and customer retention, organization and distribution, location etc. From the perspective of our research we will now review the economic models known in theory and practice for estimating the risk of bankruptcy; such models are based on indicators drawn from major accounting firms.

Keywords: Anglo-Saxon models, continental models, national models, statistical models

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Authors: Seon Soon Choi

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Magnesium alloy has been widely used in structure such as an automobile. It is necessary to consider probabilistic characteristics of a structural material because a fatigue behavior of a structure has a randomness and uncertainty. The purpose of this study is to find the characteristics of the cumulative distribution function (CDF) of the grown crack size at a specified fatigue crack propagation life and to investigate a statistical crack propagation in magnesium alloys. The statistical fatigue data of the grown crack size are obtained through the fatigue crack propagation (FCP) tests under different maximum fatigue load conditions conducted on the replicated specimens of magnesium alloys. The 3-parameter Weibull distribution is used to find the CDF of grown crack size. The CDF of grown crack size in case of larger maximum fatigue load has longer tail in below 10 percent and above 90 percent. The fatigue failure occurs easily as the tail of CDF of grown crack size becomes long. The fatigue behavior under the larger maximum fatigue load condition shows more rapid propagation and failure mode.

Keywords: cumulative distribution function, fatigue crack propagation, grown crack size, magnesium alloys, maximum fatigue load

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Authors: Noushin Shokouhinejad, Hasan Razmi, Reza Fekrazad, Saeed Asgary, Ammar Neshati, Hadi Assadian, Sanam Kheirieh

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This study compared the push-out bond strength of mineral trioxide aggregate (MTA) and a new endodontic cement (NEC) as root-end filling materials in root-end cavities prepared by ultrasonic technique (US) or Er,Cr:YSGG laser (L). Eighty single-rooted extracted human teeth were endodontically treated, apicectomised and randomly divided into four following groups (n = 20): US/MTA, US/NEC, L/MTA and L/NEC. In US/MTA and US/NEC groups, rooted cavities were prepared with ultrasonic retrotip and filled with MTA and NEC, respectively. In L/MTA and L/NEC groups, root-end cavities were prepared using Er, Cr:YSGG laser and filled with MTA and NEC, respectively. Each root was cut apically to create a 2 mm-thick root slice for measurement of bond strength using a universal testing machine. Then, all slices were examined to determine the mode of bond failure. Data were analysed using two-way ANOVA. Root-end filling materials showed significantly higher bond strength in root-end cavities prepared using the ultrasonic technique (US/MTA and US/NEC) (P < 0.001). The bond strengths of MTA and NEC did not differ significantly. The failure modes were mainly adhesive for MTA, but cohesive for NEC. In conclusion, bond strengths of MTA and NEC to root-end cavities were comparable and higher in ultrasonically prepared cavities.

Keywords: bond strength, Er, Cr:YSGG laser, MTA, NEC, root-end cavity

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