Search results for: out of pocket expenses
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 321

Search results for: out of pocket expenses

111 Synthesis of Deformed Nuclei 260Rf, 261Rf and 262Rf in the Decay of 266Rf*Formed via Different Fusion Reactions: Entrance Channel Effects

Authors: Niyti, Aman Deep, Rajesh Kharab, Sahila Chopra, Raj. K. Gupta

Abstract:

Relatively long-lived transactinide elements (i.e., elements with atomic number Z≥104) up to Z = 108 have been produced in nuclear reactions between low Z projectiles (C to Al) and actinide targets. Cross sections have been observed to decrease steeply with increasing Z. Recently, production cross sections of several picobarns have been reported for comparatively neutron-rich nuclides of 112 through 118 produced via hot fusion reactions with 48Ca and actinide targets. Some of those heavy nuclides are reported to have lifetimes on the order of seconds or longer. The relatively high cross sections in these hot fusion reactions are not fully understood and this has renewed interest in systematic studies of heavy-ion reactions with actinide targets. The main aim of this work is to understand the dynamics hot fusion reactions 18O+ 248Cm and 22Ne+244Pu (carried out at RIKEN and TASCA respectively) using the collective clusterization technique, carried out by undertaking the decay of the compound nucleus 266Rf∗ into 4n, 5n and 6n neutron evaporation channels. Here we extend our earlier study of the excitation functions (EFs) of 266Rf∗, formed in fusion reaction 18O+248Cm, based on Dynamical Cluster-decay Model (DCM) using the pocket formula for nuclear proximity potential, to the use of other nuclear interaction potentials derived from Skyrme energy density formalism (SEDF) based on semiclassical extended Thomas Fermi (ETF) approach and also study entrance channel effects by considering the synthesis of 266Rf* in 22Ne+244Pu reaction. The Skyrme forces used are the old force SIII, and new forces GSkI and KDE0(v1). Here, the EFs for the production of 260Rf, 261Rf and 262Rf isotope via 6n, 5n and 4n decay channel from the 266Rf∗ compound nucleus are studied at Elab = 88.2 to 125 MeV, including quadrupole deformations β2i and ‘hot-optimum’ orientations θi. The calculations are made within the DCM where the neck-length ∆R is the only parameter representing the relative separation distance between two fragments and/or clusters Ai which assimilates the neck formation effects.

Keywords: entrance channel effects, fusion reactions, skyrme force, superheavy nucleus

Procedia PDF Downloads 253
110 Optimum Dewatering Network Design Using Firefly Optimization Algorithm

Authors: S. M. Javad Davoodi, Mojtaba Shourian

Abstract:

Groundwater table close to the ground surface causes major problems in construction and mining operation. One of the methods to control groundwater in such cases is using pumping wells. These pumping wells remove excess water from the site project and lower the water table to a desirable value. Although the efficiency of this method is acceptable, it needs high expenses to apply. It means even small improvement in a design of pumping wells can lead to substantial cost savings. In order to minimize the total cost in the method of pumping wells, a simulation-optimization approach is applied. The proposed model integrates MODFLOW as the simulation model with Firefly as the optimization algorithm. In fact, MODFLOW computes the drawdown due to pumping in an aquifer and the Firefly algorithm defines the optimum value of design parameters which are numbers, pumping rates and layout of the designing wells. The developed Firefly-MODFLOW model is applied to minimize the cost of the dewatering project for the ancient mosque of Kerman city in Iran. Repetitive runs of the Firefly-MODFLOW model indicates that drilling two wells with the total rate of pumping 5503 m3/day is the result of the minimization problem. Results show that implementing the proposed solution leads to at least 1.5 m drawdown in the aquifer beneath mosque region. Also, the subsidence due to groundwater depletion is less than 80 mm. Sensitivity analyses indicate that desirable groundwater depletion has an enormous impact on total cost of the project. Besides, in a hypothetical aquifer decreasing the hydraulic conductivity contributes to decrease in total water extraction for dewatering.

Keywords: groundwater dewatering, pumping wells, simulation-optimization, MODFLOW, firefly algorithm

Procedia PDF Downloads 294
109 Bank, Stock Market Efficiency and Economic Growth: Lessons for ASEAN-5

Authors: Tan Swee Liang

Abstract:

This paper estimates bank and stock market efficiency associations with real per capita GDP growth by examining panel-data across three different regions using Panel-Corrected Standard Errors (PCSE) regression developed by Beck and Katz (1995). Data from five economies in ASEAN (Singapore, Malaysia, Thailand, Philippines, and Indonesia), five economies in Asia (Japan, China, Hong Kong SAR, South Korea, and India) and seven economies in OECD (Australia, Canada, Denmark, Norway, Sweden, United Kingdom U.K., and United States U.S.), between 1990 and 2017 are used. Empirical findings suggest one, for Asia-5 high bank net interest margin means greater bank profitability, hence spurring economic growth. Two, for OECD-7 low bank overhead costs (as a share of total assets) may reflect weak competition and weak investment in providing superior banking services, hence dampening economic growth. Three, stock market turnover ratio has negative association with OECD-7 economic growth, but a positive association with Asia-5, which suggest the relationship between liquidity and growth is ambiguous. Lastly, for ASEAN-5 high bank overhead costs (as a share of total assets) may suggest expenses have not been channelled efficiently to income generating activities. One practical implication of the findings is that policy makers should take necessary measures toward financial liberalisation policies that boost growth through the efficiency channel, so that funds are efficiently allocated through the financial system between financial and real sectors.

Keywords: financial development, banking system, capital markets, economic growth

Procedia PDF Downloads 138
108 Assessing Household Energy Savings and Consumer Behavior in Padang City

Authors: Prima Fithri, Lusi Susanti, Karin Bestarina

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Indonesia's electrification ratio is still around 80.1%, which means that approximately 19.9% of households in Indonesia have not been getting the flow of electrical energy. Household electricity consumptions in Indonesia are generally still dominated by the public urban. In the city of Padang, West Sumatera, Indonesia, about 94.10% are power users of government services (PLN). The most important thing of the issue is human resources efficient energy. Consumer behavior in utilizing electricity becomes significant. Intensive questioner survey, in-depth interview and statistical analysis are carried out to collect scientific evidences of the behavioral based changes instruments to reduce electricity consumption in household sector. The questioner was developed to include five factors assuming affect the electricity consumption pattern in household sector. They are: attitude, energy price, household income, knowledge and other determinants. The survey was carried out in Padang, West Sumatra Province Indonesia. About 210 questioner papers were proportionally distributed to households in 11 districts in Padang. Stratified sampling was used as a method to select respondents. The results show that the household size, income, payment methods and size of house are factors affecting electricity saving behavior in residential sector. Household expenses on electricity are strongly influenced by gender, type of job, level of education, size of house, income, payment method and level of installed power. These results provide a scientific evidence for stakeholders on the potential of controlling electricity consumption and designing energy policy by government in residential sector.

Keywords: electricity, energy saving, household, behavior, policy

Procedia PDF Downloads 523
107 Energy Production with Closed Methods

Authors: Bujar Ismaili, Bahti Ismajli, Venhar Ismaili, Skender Ramadani

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In Kosovo, the problem with the electricity supply is huge and does not meet the demands of consumers. Older thermal power plants, which are regarded as big environmental polluters, produce most of the energy. Our experiment is based on the production of electricity using the closed method that does not affect environmental pollution by using waste as fuel that is considered to pollute the environment. The experiment was carried out in the village of Godanc, municipality of Shtime - Kosovo. In the experiment, a production line based on the production of electricity and central heating was designed at the same time. The results are the benefits of electricity as well as the release of temperature for heating with minimal expenses and with the release of 0% gases into the atmosphere. During this experiment, coal, plastic, waste from wood processing, and agricultural wastes were used as raw materials. The method utilized in the experiment allows for the release of gas through pipes and filters during the top-to-bottom combustion of the raw material in the boiler, followed by the method of gas filtration from waste wood processing (sawdust). During this process, the final product is obtained - gas, which passes through the carburetor, which enables the gas combustion process and puts into operation the internal combustion machine and the generator and produces electricity that does not release gases into the atmosphere. The obtained results show that the system provides energy stability without environmental pollution from toxic substances and waste, as well as with low production costs. From the final results, it follows that: in the case of using coal fuel, we have benefited from more electricity and higher temperature release, followed by plastic waste, which also gave good results. The results obtained during these experiments prove that the current problems of lack of electricity and heating can be met at a lower cost and have a clean environment and waste management.

Keywords: energy, heating, atmosphere, waste, gasification

Procedia PDF Downloads 235
106 Quantifying the Impact of Climate Change on Agritourism: The Transformative Role of Solar Energy in Enhancing Growth and Resilience in Eritrea

Authors: Beyene Daniel, Herbert Ntuli

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Agritourism in Eritrea is increasingly threatened by climate change, manifesting through rising temperatures, shifting rainfall patterns, and resource scarcity. This study employs quantitative methods to assess the economic and environmental impacts of climate change on agritourism, utilizing metrics such as annual income fluctuations, changes in visitor numbers, and energy consumption patterns. The methodology relies on secondary data sourced from the World Bank, government reports, and academic publications to analyze the economic viability of integrating solar energy into agritourism operations. Key variables include the Benefits from Renewable Energy (BRE), encompassing cost savings from reduced energy expenses and the monetized value of avoided greenhouse gas emissions. Using a net present value (NPV) framework, the research compares the impact of solar energy against traditional fossil fuel sources by evaluating the Value of Reduced Greenhouse Gas Emissions (CO2) and the Value of Health-Related Costs (VHRC) due to air pollution. The preliminary findings of this research are of utmost importance. They indicate that the adoption of solar energy can enhance energy independence by up to 40%, reduce operational costs by 25%, and stabilize agritourism activities in climate-sensitive regions. This research aims to provide actionable insights for policymakers and stakeholders, supporting the sustainable development of agritourism in Eritrea and contributing to broader climate adaptation strategies. By employing a comprehensive cost-benefit analysis, the study highlights the economic advantages and environmental benefits of transitioning to renewable energy in the face of climate change.

Keywords: climate change, renewable energy, resilience, cost-benefit analysis

Procedia PDF Downloads 14
105 Technical Sustainable Management: An Instrument to Increase Energy Efficiency in Wastewater Treatment Plants, a Case Study in Jordan

Authors: Dirk Winkler, Leon Koevener, Lamees AlHayary

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This paper contributes to the improvement of the municipal wastewater systems in Jordan. An important goal is increased energy efficiency in wastewater treatment plants and therefore lower expenses due to reduced electricity consumption. The chosen way to achieve this goal is through the implementation of Technical Sustainable Management adapted to the Jordanian context. Three wastewater treatment plants in Jordan have been chosen as a case study for the investigation. These choices were supported by the fact that the three treatment plants are suitable for average performance and size. Beyond that, an energy assessment has been recently conducted in those facilities. The project succeeded in proving the following hypothesis: Energy efficiency in wastewater treatment plants can be improved by implementing principles of Technical Sustainable Management adapted to the Jordanian context. With this case study, a significant increase in energy efficiency can be achieved by optimization of operational performance, identifying and eliminating shortcomings and appropriate plant management. Implementing Technical Sustainable Management as a low-cost tool with a comparable little workload, provides several additional benefits supplementing increased energy efficiency, including compliance with all legal and technical requirements, process optimization, but also increased work safety and convenient working conditions. The research in the chosen field continues because there are indications for possible integration of the adapted tool into other regions and sectors. The concept of Technical Sustainable Management adapted to the Jordanian context could be extended to other wastewater treatment plants in all regions of Jordan but also into other sectors including water treatment, water distribution, wastewater network, desalination, or chemical industry.

Keywords: energy efficiency, quality management system, technical sustainable management, wastewater treatment

Procedia PDF Downloads 162
104 Weighing the Economic Cost of Illness Due to Dysentery and Cholera Triggered by Poor Sanitation in Rural Faisalabad, Pakistan

Authors: Syed Asif Ali Naqvi, Muhammad Azeem Tufail

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Inadequate sanitation causes direct costs of treating illnesses and loss of income through reduced productivity. This study estimated the economic cost of health (ECH) due to poor sanitation and factors determining the lack of access to latrine for the rural, backward hamlets and slums of district Faisalabad, Pakistan. Cross sectional data were collected and analyzed for the study. As the population under study was homogenous in nature, it is why a simple random sampling technique was used for the collection of data. Data of 440 households from 4 tehsils were gathered. The ordinary least square (OLS) model was used for health cost analysis, and the Probit regression model was employed for determining the factors responsible for inaccess to toilets. The results of the study showed that condition of toilets, situation of sewerage system, access to adequate sanitation, Cholera, diarrhea and dysentery, Water and Sanitation Agency (WASA) maintenance, source of medical treatment can plausibly have a significant connection with the dependent variable. Outcomes of the second model showed that the variables of education, family system, age, and type of dwelling have positive and significant sway with the dependent variable. Variable of age depicted an insignificant association with access to toilets. Variable of monetary expenses would negatively influence the dependent variable. Findings revealed the fact, health risks are often exacerbated by inadequate sanitation, and ultimately, the cost on health also surges. Public and community toilets for youths and social campaigning are suggested for public policy.

Keywords: sanitation, toilet, economic cost of health, water, Punjab

Procedia PDF Downloads 120
103 From Parchment to Pixels: Digital Preservation for the Future

Authors: Abida Khatoon

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This study provides an overview of ancient manuscripts, including their historical significance, current digital preservation methods, and the challenges we face in safeguarding these invaluable resources. India has a long-standing tradition of manuscript preservation, with texts that span a wide range of subjects, from religious scriptures to scientific treatises. These manuscripts were written on various materials, including palm leaves, parchment, metal, bark, wood, animal skin, and paper. These manuscripts offer a deep insight into India's cultural and intellectual history. Ancient manuscripts are crucial historical records, providing valuable insights into past civilizations and knowledge systems. As these physical documents become increasingly fragile, digital preservation methods have become essential to ensure their continued accessibility. Digital preservation involves several key techniques. Scanning and digitization create high-resolution digital images of manuscripts, while reprography produces copies to reduce wear on originals. Digital archiving ensures proper storage and management of these digital files, and preservation of electronic data addresses modern formats like web pages and emails. Despite its benefits, digital preservation faces several challenges. Technological obsolescence, data integrity issues, and the resource-intensive nature of the process are significant hurdles. Securing adequate funding is particularly challenging due to high initial costs and ongoing expenses. Looking ahead, the future of digital preservation is promising. Advancements in technology, increased collaboration among institutions, and the development of sustainable funding models will enhance the preservation and accessibility of these important historical documents.

Keywords: preservation strategies, Indian manuscript, cultural heritage, archiving

Procedia PDF Downloads 18
102 Handy EKG: Low-Cost ECG For Primary Care Screening In Developing Countries

Authors: Jhiamluka Zservando Solano Velasquez, Raul Palma, Alejandro Calderon, Servio Paguada, Erick Marin, Kellyn Funes, Hana Sandoval, Oscar Hernandez

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Background: Screening cardiac conditions in primary care in developing countries can be challenging, and Honduras is not the exception. One of the main limitations is the underfunding of the Healthcare System in general, causing conventional ECG acquisition to become a secondary priority. Objective: Development of a low-cost ECG to improve screening of arrhythmias in primary care and communication with a specialist in secondary and tertiary care. Methods: Design a portable, pocket-size low-cost 3 lead ECG (Handy EKG). The device is autonomous and has Wi-Fi/Bluetooth connectivity options. A mobile app was designed which can access online servers with machine learning, a subset of artificial intelligence to learn from the data and aid clinicians in their interpretation of readings. Additionally, the device would use the online servers to transfer patient’s data and readings to a specialist in secondary and tertiary care. 50 randomized patients volunteer to participate to test the device. The patients had no previous cardiac-related conditions, and readings were taken. One reading was performed with the conventional ECG and 3 readings with the Handy EKG using different lead positions. This project was possible thanks to the funding provided by the National Autonomous University of Honduras. Results: Preliminary results show that the Handy EKG performs readings of the cardiac activity similar to those of a conventional electrocardiograph in lead I, II, and III depending on the position of the leads at a lower cost. The wave and segment duration, amplitude, and morphology of the readings were similar to the conventional ECG, and interpretation was possible to conclude whether there was an arrhythmia or not. Two cases of prolonged PR segment were found in both ECG device readings. Conclusion: Using a Frugal innovation approach can allow lower income countries to develop innovative medical devices such as the Handy EKG to fulfill unmet needs at lower prices without compromising effectiveness, safety, and quality. The Handy EKG provides a solution for primary care screening at a much lower cost and allows for convenient storage of the readings in online servers where clinical data of patients can then be accessed remotely by Cardiology specialists.

Keywords: low-cost hardware, portable electrocardiograph, prototype, remote healthcare

Procedia PDF Downloads 180
101 Quantifying the Impact of Climate Change on Agritourism: The Transformative Role of Solar Energy in Enhancing Growth and Resilience in Eritrea

Authors: Beyene Daniel Abrha

Abstract:

Agritourism in Eritrea is increasingly threatened by climate change, manifesting through rising temperatures, shifting rainfall patterns, and resource scarcity. This study employs quantitative methods to assess the economic and environmental impacts of climate change on agritourism, utilizing metrics such as annual income fluctuations, changes in visitor numbers, and energy consumption patterns. The methodology relies on secondary data sourced from the World Bank, government reports, and academic publications to analyze the economic viability of integrating solar energy into agritourism operations. Key variables include the Benefits from Renewable Energy (BRE), encompassing cost savings from reduced energy expenses and the monetized value of avoided greenhouse gas emissions. Using a net present value (NPV) framework, the research compares the impact of solar energy against traditional fossil fuel sources by evaluating the Value of Reduced Greenhouse Gas Emissions (CO2) and the Value of Health-Related Costs (VHRC) due to air pollution. The preliminary findings of this research are of utmost importance. They indicate that the adoption of solar energy can enhance energy independence by up to 40%, reduce operational costs by 25%, and stabilize agritourism activities in climate-sensitive regions. This research aims to provide actionable insights for policymakers and stakeholders, supporting the sustainable development of agritourism in Eritrea and contributing to broader climate adaptation strategies. By employing a comprehensive cost-benefit analysis, the study highlights the economic advantages and environmental benefits of transitioning to renewable energy in the face of climate change.

Keywords: agritourism, climate change, renewable energy, cost benefit analysis, resilience, cost-benefit analysis

Procedia PDF Downloads 10
100 Storm-water Management for Greenfield Area Using Low Impact Development Concept for Town Planning Scheme Mechanism

Authors: Sahil Patel

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Increasing urbanization leads to a concrete forest. The effects of new development practices occur in the natural hydrologic cycle. Here the concerns have been raised about the groundwater recharge in sufficient quantity. With further development, porous surfaces reduce rapidly. A city like Ahmedabad, with a non-perennial river, is 100% dependent on groundwater. The Ahmedabad city receives its domestic use water from the Narmada river, located about 200 km away. The expenses to bring water is much higher. Ahmedabad city receives annually 800 mm rainfall, and mostly this water increases the local level waterlogging problems; after that, water goes to the Sabarmati river and merges into the sea. The existing developed area of Ahmedabad city is very dense, and does not offer many chances to change the built form and increase porous surfaces to absorb storm-water. Therefore, there is a need to plan upcoming areas with more effective solutions to manage storm-water. This paper is focusing on the management of stormwater for new development by retaining natural hydrology. The Low Impact Development (LID) concept is used to manage storm-water efficiently. Ahmedabad city has a tool called the “Town Planning Scheme,” which helps the local body drive new development by land pooling mechanism. This paper gives a detailed analysis of the selected area (proposed Town Planning Scheme area by the local authority) in Ahmedabad. Here the development control regulations for individual developers and some physical elements for public places are presented to manage storm-water. There is a different solution for the Town Planning scheme than that of the conventional way. A local authority can use it for any area, but it can be site-specific. In the end, there are benefits to locals with some financial analysis and comparisons.

Keywords: water management, green field development, low impact development, town planning scheme

Procedia PDF Downloads 130
99 The Impact of Bim Technology on the Whole Process Cost Management of Civil Engineering Projects in Kenya

Authors: Nsimbe Allan

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The study examines the impact of Building Information Modeling (BIM) on the cost management of engineering projects, focusing specifically on the Mombasa Port Area Development Project. The objective of this research venture is to determine the mechanisms through which Building Information Modeling (BIM) facilitates stakeholder collaboration, reduces construction-related expenses, and enhances the precision of cost estimation. Furthermore, the study investigates barriers to execution, assesses the impact on the project's transparency, and suggests approaches to maximize resource utilization. The study, selected for its practical significance and intricate nature, conducted a Systematic Literature Review (SLR) using credible databases, including ScienceDirect and IEEE Xplore. To constitute the diverse sample, 69 individuals, including project managers, cost estimators, and BIM administrators, were selected via stratified random sampling. The data were obtained using a mixed-methods approach, which prioritized ethical considerations. SPSS and Microsoft Excel were applied to the analysis. The research emphasizes the crucial role that project managers, architects, and engineers play in the decision-making process (47% of respondents). Furthermore, a significant improvement in cost estimation accuracy was reported by 70% of the participants. It was found that the implementation of BIM resulted in enhanced project visibility, which in turn optimized resource allocation and facilitated the process of budgeting. In brief, the study highlights the positive impacts of Building Information Modeling (BIM) on collaborative decision-making and cost estimation, addresses challenges related to implementation, and provides solutions for the efficient assimilation and understanding of BIM principles.

Keywords: cost management, resource utilization, stakeholder collaboration, project transparency

Procedia PDF Downloads 67
98 Hybrid Energy System for the German Mining Industry: An Optimized Model

Authors: Kateryna Zharan, Jan C. Bongaerts

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In recent years, economic attractiveness of renewable energy (RE) for the mining industry, especially for off-grid mines, and a negative environmental impact of fossil energy are stimulating to use RE for mining needs. Being that remote area mines have higher energy expenses than mines connected to a grid, integration of RE may give a mine economic benefits. Regarding the literature review, there is a lack of business models for adopting of RE at mine. The main aim of this paper is to develop an optimized model of RE integration into the German mining industry (GMI). Hereby, the GMI with amount of around 800 mill. t. annually extracted resources is included in the list of the 15 major mining country in the world. Accordingly, the mining potential of Germany is evaluated in this paper as a perspective market for RE implementation. The GMI has been classified in order to find out the location of resources, quantity and types of the mines, amount of extracted resources, and access of the mines to the energy resources. Additionally, weather conditions have been analyzed in order to figure out where wind and solar generation technologies can be integrated into a mine with the highest efficiency. Despite the fact that the electricity demand of the GMI is almost completely covered by a grid connection, the hybrid energy system (HES) based on a mix of RE and fossil energy is developed due to show environmental and economic benefits. The HES for the GMI consolidates a combination of wind turbine, solar PV, battery and diesel generation. The model has been calculated using the HOMER software. Furthermore, the demonstrated HES contains a forecasting model that predicts solar and wind generation in advance. The main result from the HES such as CO2 emission reduction is estimated in order to make the mining processing more environmental friendly.

Keywords: diesel generation, German mining industry, hybrid energy system, hybrid optimization model for electric renewables, optimized model, renewable energy

Procedia PDF Downloads 343
97 The Impact of Effective Employee Retention Strategies to the Success of the Hotel Industry of Rwanda

Authors: Ange Meghane Hakizimana, Landry Ndikuriyo

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Retention of employees in the hospitality industry is a recurrent agenda in the organization involving all the combined efforts to maintain the best available laborer. The general objective of this research is to assess the impact of effective employee retention strategies on the success of the hotel industry at Galileo Hotel, Huye District in Rwanda, for the period of 2019-2021. Herzberg Two Factor Theory and Equity Theory were used. The study adopted a descriptive research design. Descriptive research design allowed us to study the elements in their natural form without making any alterations to them. Secondary data and primary data and the data collected were sorted and entered into the statistical packages for social sciences for analysis (SPSS) version 26. Frequencies, descriptive statistics and percentages were used to analyze and establish extent to which employee retention strategies impact the success of the hotel industry of Rwanda and this was analyzed using regression and correlation analysis. The results revealed that employee training and development had an influence of 24.8% on the success of the hotel industry in Rwanda. According to the results of our study, the employee reward system contributes 20.7% to the success of the hotel industry in Rwanda, the value of t is 3.475 and this is greater than the standard t value score of 1.96, p-value is 0.002. Therefore the employee reward system has a great positive impact on the success of the hotel industry in Rwanda. The results also show that 15.7% of the success of the hospitality industry in Rwanda is due to the work environment of employees. With a t-value of 4.384 and a p-value of 0.000, the above statistics show a positive impact of the employees' working environment on success of the hospitality industry in Rwanda. A priority to the retention of their employees should be given by the hotel industry and its managers because it has already been proven that it is an effective approach to offering good customer service. In addition, employee retention reduces expenses associated with employee recruitment and turnover.

Keywords: success, hotel industry, training and development, employee reward system, employee work environment

Procedia PDF Downloads 96
96 Computational Approach to Identify Novel Chemotherapeutic Agents against Multiple Sclerosis

Authors: Syed Asif Hassan, Tabrej Khan

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Multiple sclerosis (MS) is a chronic demyelinating autoimmune disorder, of the central nervous system (CNS). In the present scenario, the current therapies either do not halt the progression of the disease or have side effects which limit the usage of current Disease Modifying Therapies (DMTs) for a longer period of time. Therefore, keeping the current treatment failure schema, we are focusing on screening novel analogues of the available DMTs that specifically bind and inhibit the Sphingosine1-phosphate receptor1 (S1PR1) thereby hindering the lymphocyte propagation toward CNS. The novel drug-like analogs molecule will decrease the frequency of relapses (recurrence of the symptoms associated with MS) with higher efficacy and lower toxicity to human system. In this study, an integrated approach involving ligand-based virtual screening protocol (Ultrafast Shape Recognition with CREDO Atom Types (USRCAT)) to identify the non-toxic drug like analogs of the approved DMTs were employed. The potency of the drug-like analog molecules to cross the Blood Brain Barrier (BBB) was estimated. Besides, molecular docking and simulation using Auto Dock Vina 1.1.2 and GOLD 3.01 were performed using the X-ray crystal structure of Mtb LprG protein to calculate the affinity and specificity of the analogs with the given LprG protein. The docking results were further confirmed by DSX (DrugScore eXtented), a robust program to evaluate the binding energy of ligands bound to the ligand binding domain of the Mtb LprG lipoprotein. The ligand, which has a higher hypothetical affinity, also has greater negative value. Further, the non-specific ligands were screened out using the structural filter proposed by Baell and Holloway. Based on the USRCAT, Lipinski’s values, toxicity and BBB analysis, the drug-like analogs of fingolimod and BG-12 showed that RTL and CHEMBL1771640, respectively are non-toxic and permeable to BBB. The successful docking and DSX analysis showed that RTL and CHEMBL1771640 could bind to the binding pocket of S1PR1 receptor protein of human with greater affinity than as compared to their parent compound (Fingolimod). In this study, we also found that all the drug-like analogs of the standard MS drugs passed the Bell and Holloway filter.

Keywords: antagonist, binding affinity, chemotherapeutics, drug-like, multiple sclerosis, S1PR1 receptor protein

Procedia PDF Downloads 256
95 The Study of Heat and Mass Transfer for Ferrous Materials' Filtration Drying

Authors: Dmytro Symak

Abstract:

Drying is a complex technologic, thermal and energy process. Energy cost of drying processes in many cases is the most costly stage of production, and can be over 50% of total costs. As we know, in Ukraine over 85% of Portland cement is produced moist, and the finished product energy costs make up to almost 60%. During the wet cement production, energy costs make up over 5500 kJ / kg of clinker, while during the dry only 3100 kJ / kg, that is, switching to a dry Portland cement will allow result into double cutting energy costs. Therefore, to study raw materials drying process in the manufacture of Portland cement is very actual task. The fine ferrous materials drying (small pyrites, red mud, clay Kyoko) is recommended to do by filtration method, that is one of the most intense. The essence of filtration method drying lies in heat agent filtering through a stationary layer of wet material, which is located on the perforated partition, in the "layer-dispersed material - perforated partition." For the optimum drying purposes, it is necessary to establish the dependence of pressure loss in the layer of dispersed material, and the values of heat and mass transfer, depending on the speed of the gas flow filtering. In our research, the experimentally determined pressure loss in the layer of dispersed material was generalized based on dimensionless complexes in the form and coefficients of heat exchange. We also determined the relation between the coefficients of mass and heat transfer. As a result of theoretic and experimental investigations, it was possible to develop a methodology for calculating the optimal parameters for the thermal agent and the main parameters for the filtration drying installation. The comparison of calculated by known operating expenses methods for the process of small pyrites drying in a rotating drum and filtration method shows to save up to 618 kWh per 1,000 kg of dry material and 700 kWh during filtration drying clay.

Keywords: drying, cement, heat and mass transfer, filtration method

Procedia PDF Downloads 262
94 Cost Overrun in Construction Projects

Authors: Hailu Kebede Bekele

Abstract:

Construction delays are suitable where project events occur at a certain time expected due to causes related to the client, consultant, and contractor. Delay is the major cause of the cost overrun that leads to the poor efficiency of the project. The cost difference between completion and the originally estimated is known as cost overrun. The common ways of cost overruns are not simple issues that can be neglected, but more attention should be given to prevent the organization from being devastated to be failed, and financial expenses to be extended. The reasons that may raised in different studies show that the problem may arise in construction projects due to errors in budgeting, lack of favorable weather conditions, inefficient machinery, and the availability of extravagance. The study is focused on the pace of mega projects that can have a significant change in the cost overrun calculation.15 mega projects are identified to study the problem of the cost overrun in the site. The contractor, consultant, and client are the principal stakeholders in the mega projects. 20 people from each sector were selected to participate in the investigation of the current mega construction project. The main objective of the study on the construction cost overrun is to prioritize the major causes of the cost overrun problem. The methodology that was employed in the construction cost overrun is the qualitative methodology that mostly rates the causes of construction project cost overrun. Interviews, open-ended and closed-ended questions group discussions, and rating qualitative methods are the best methodologies to study construction projects overrun. The result shows that design mistakes, lack of labor, payment delay, old equipment and scheduling, weather conditions, lack of skilled labor, payment delays, transportation, inflation, and order variations, market price fluctuation, and people's thoughts and philosophies, the prior cause of the cost overrun that fail the project performance. The institute shall follow the scheduled activities to bring a positive forward in the project life.

Keywords: cost overrun, delay, mega projects, design

Procedia PDF Downloads 62
93 Impacts of Public Insurance on Health Access and Outcomes: Evidence from India

Authors: Titir Bhattacharya, Tanika Chakraborty, Prabal K. De

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Maternal and child health continue to be a significant policy focus in developing countries, including India. An emerging model in health care is the creation of public and private partnerships. Since the construction of physical infrastructure is costly, governments at various levels have tried to implement social health insurance schemes where a trust calculates insurance premiums and medical payments. Typically, qualifying families get full subsidization of the premium and get access to private hospitals, in addition to low cost public hospitals, for their tertiary care needs. We analyze one such pioneering social insurance scheme in the Indian state of Andhra Pradesh (AP). The Rajiv Aarogyasri program (RA) was introduced by the Government of AP on a pilot basis in 2007 and implemented in 2008. In this paper, we first examine the extent to which access to reproductive health care changed. For example, the RA scheme reimburses hospital deliveries leading us to expect an increase in institutional deliveries, particularly in private hospitals. Second, we expect an increase in institutional deliveries to also improve child health outcomes. Hence, we estimate if the program improved infant and child mortality. We use District Level Health Survey data to create annual birth cohorts from 2000-2015. Since AP was the only state in which such a state insurance program was implemented, the neighboring states constituted a plausible control group. Combined with the policy timing, and the year of birth, we employ a difference-indifference strategy to identify the effects of RA on the residents of AP. We perform several checks against threats to identification, including testing for pre-treatment trends between the treatment and control states. We find that the policy significantly lowered infant and child mortality in AP. We also find that deliveries in private hospitals increased, and government hospitals decreased, showing a substitution effect of the relative price change. Finally, as expected, out-of-pocket costs declined for the treatment group. However, we do not find any significant effects for usual preventive care such as vaccination, showing that benefits of insurance schemes targeted at the tertiary level may not trickle down to the primary care level.

Keywords: public health insurance, maternal and child health, public-private choice

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92 The Study of Periodontal Health Status in Menopausal Women with Osteoporosis Referred to Rheumatology Clinics in Yazd and Healthy People

Authors: Mahboobe Daneshvar

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Introduction: Clinical studies on the effect of systemic conditions on periodontal diseases have shown that some systemic deficiencies may provide grounds for the onset of periodontal diseases. One of these systemic problems is osteoporosis, which may be a risk factor for the onset and exacerbation of periodontitis. This study tends to evaluate periodontal indices in osteoporotic menopausal women and compare them with healthy controls. Materials and Methods: In this case-control study, participants included 45-75-year-old menopausal women referred to rheumatology wards of the Khatamolanbia Clinic and Shahid Sadoughi Hospital in Yazd; Their bone density was determined by DEXA-scan and by imaging the femoral-lumbar bone. Thirty patients with osteoporosis and 30 subjects with normal BMD were selected. Then, informed consent was obtained for participation in the study. During the clinical examinations, tooth loss (TL), plaque index (PI), gingival recession, pocket probing depth (PPD), clinical attachment loss (CAL), and tooth mobility (TM) were measured to evaluate the periodontal status. These clinical examinations were performed to determine the periodontal status by catheter, mirror and probe. Results: During the evaluation, there was no significant difference in PPD, PI, TM, gingival recession, and CAL between case and control groups (P-value>0.05); that is, osteoporosis has no effect on the above factors. These periodontal factors are almost the same in both healthy and patient groups. In the case of missing teeth, the following results were obtained: the mean of missing teeth was 22.173% of the total teeth in the case group and 18.583% of the total teeth in the control group. In the study of the missing teeth in the case and control groups, there was a significant relationship between case and control groups (P-value = 0.025). Conclusion: In fact, since periodontal disease is multifactorial and microbial plaque is the main cause, osteoporosis is considered a predisposing factor in exacerbation or persistence of periodontal disease. In patients with osteoporosis, usually pathological fractures, hormonal changes, and aging lead to reduced physical activity and affect oral health, which leads to the manifestation of periodontal disease. But this disease increases tooth loss by changing the shape and structure of bone trabeculae and weakening them. Osteoporosis does not seem to be a deterministic factor in the incidence of periodontal disease, since it affects bone quality rather than bone quantity.

Keywords: plaque index, Osteoporosis, tooth mobility, periodontal packet

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91 A Mathematical Model to Select Shipbrokers

Authors: Y. Smirlis, G. Koronakos, S. Plitsos

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Shipbrokers assist the ship companies in chartering or selling and buying vessels, acting as intermediates between them and the market. They facilitate deals, providing their expertise, negotiating skills, and knowledge about ship market bargains. Their role is very important as it affects the profitability and market position of a shipping company. Due to their significant contribution, the shipping companies have to employ systematic procedures to evaluate the shipbrokers’ services in order to select the best and, consequently, to achieve the best deals. Towards this, in this paper, we consider shipbrokers as financial service providers, and we formulate the problem of evaluating and selecting shipbrokers’ services as a multi-criteria decision making (MCDM) procedure. The proposed methodology comprises a first normalization step to adjust different scales and orientations of the criteria and a second step that includes the mathematical model to evaluate the performance of the shipbrokers’ services involved in the assessment. The criteria along which the shipbrokers are assessed may refer to their size and reputation, the potential efficiency of the services, the terms and conditions imposed, the expenses (e.g., commission – brokerage), the expected time to accomplish a chartering or selling/buying task, etc. and according to our modelling approach these criteria may be assigned different importance. The mathematical programming model performs a comparative assessment and estimates for the shipbrokers involved in the evaluation, a relative score that ranks the shipbrokers in terms of their potential performance. To illustrate the proposed methodology, we present a case study in which a shipping company evaluates and selects the most suitable among a number of sale and purchase (S&P) brokers. Acknowledgment: This study is supported by the OptiShip project, implemented within the framework of the National Recovery Plan and Resilience “Greece 2.0” and funded by the European Union – NextGenerationEU programme.

Keywords: shipbrokers, multi-criteria decision making, mathematical programming, service-provider selection

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90 Harmonization of Financial Information Systems in Latin America in Light of International Public Sector Accounting Standards Using the Herfindahl-Hirschman Index

Authors: Laura Sour

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Government accounting is an essential instrument of transparency and accountability in public administration, which allows connecting internal management with the implementation of policies and their evaluation by third parties through the construction of indicators on the cost of government. Several countries have adopted the International Public Sector Accounting Standards (IPSAS) as part of their modernization strategy. This document will evaluate the quantity and harmonization of the financial information published in the financial statements of 12 Latin American countries based on what is established in IPSAS 1, 2 and 17. For this, seven types of financial statements are analyzed. published during the period from 2015 to 2019. Based on this information, it will be possible to describe the evolution in the government financial publication to carry out a detailed analysis of the items that have been most transparent in these countries. Finally, the level of harmonization of the financial statements will be studied using the Herfindahl-Hirschman index (IHH) to determine the degree of comparability of the information. To date, the results indicate that the public sector has increased the quantity and harmonization of the financial information published during the study period, but in a heterogeneous way: From the data collected, it has been found that the financial statement published with greater frequency and quantity is the Income Statement (classification of expenses by nature). On the other hand, the most complete reports were published by Costa Rica (2017 to 2019) and Mexico (2016 to 2018), periods during which these countries complied with 92.9 percent of the items analyzed. Although 2017 and 2018 are the years in which the most financial statements were reported, it is important to mention that Mexico is the country that has published the most financial information throughout the entire study period. The use of the IHH is expected to provide accurate information on the quality with which countries have adopted IPSAS within their government accounting systems to promote transparency and accountability in the continent.

Keywords: accounting and auditing, government policy and regulation, harmonization, public sector accounting and audits IPSAS

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89 Optimizing Organizational Performance: The Critical Role of Headcount Budgeting in Strategic Alignment and Financial Stability

Authors: Shobhit Mittal

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Headcount budgeting stands as a pivotal element in organizational financial management, extending beyond traditional budgeting to encompass strategic resource allocation for workforce-related expenses. This process is integral to maintaining financial stability and fostering a productive workforce, requiring a comprehensive analysis of factors such as market trends, business growth projections, and evolving workforce skill requirements. It demands a collaborative approach, primarily involving Human Resources (HR) and finance departments, to align workforce planning with an organization's financial capabilities and strategic objectives. The dynamic nature of headcount budgeting necessitates continuous monitoring and adjustment in response to economic fluctuations, business strategy shifts, technological advancements, and market dynamics. Its significance in talent management is also highlighted, aligning financial planning with talent acquisition and retention strategies to ensure a competitive edge in the market. The consequences of incorrect headcount budgeting are explored, showing how it can lead to financial strain, operational inefficiencies, and hindered strategic objectives. Examining case studies like IBM's strategic workforce rebalancing and Microsoft's shift for long-term success, the importance of aligning headcount budgeting with organizational goals is underscored. These examples illustrate that effective headcount budgeting transcends its role as a financial tool, emerging as a strategic element crucial for an organization's success. This necessitates continuous refinement and adaptation to align with evolving business goals and market conditions, highlighting its role as a key driver in organizational success and sustainability.

Keywords: strategic planning, fiscal budget, headcount planning, resource allocation, financial management, decision-making, operational efficiency, risk management, headcount budget

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88 Application of Homer Optimization to Investigate the Prospects of Hybrid Renewable Energy System in Rural Area: Case of Rwanda

Authors: Emile Niringiyimana, LI Ji Qing, Giovanni Dushimimana, Virginie Umwere

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The development and utilization of renewable energy (RE) can not only effectively reduce carbon dioxide (CO2) emissions, but also became a solution to electricity shortage mitigation in rural areas. Hybrid RE systems are promising ways to provide consistent and continuous power for isolated areas. This work investigated the prospect and cost effectiveness of hybrid system complementarity between a 100kW solar PV system and a small-scale 200kW hydropower station in the South of Rwanda. In order to establish the optimal size of a RE system with adequate sizing of system components, electricity demand, solar radiation, hydrology, climate data are utilized as system input. The average daily solar radiation in Rukarara is 5.6 kWh/m2 and average wind speed is 3.5 m/s. The ideal integrated RE system, according to Homer optimization, consists of 91.21kW PV, 146kW hydropower, 12 x 24V li-ion batteries with a 20kW converter. The method of enhancing such hybrid systems control, sizing and choice of components is to reduce the Net present cost (NPC) of the system, unmet load, the cost of energy and reduction of CO2. The power consumption varies according to dominant source of energy in the system by controlling the energy compensation depending on the generation capacity of each power source. The initial investment of the RE system is $977,689.25, and its operation and maintenance expenses is $142,769.39 over a 25-year period. Although the investment is very high, the targeted profits in future are huge, taking into consideration of high investment in rural electrification structure implementations, tied with an increase of electricity cost and the 5 years payback period. The study outcomes suggest that the standalone hybrid PV-Hydropower system is feasible with zero pollution in Rukara community.

Keywords: HOMER optimization, hybrid power system, renewable energy, NPC and solar pv systems

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87 Optimization of Titanium Leaching Process Using Experimental Design

Authors: Arash Rafiei, Carroll Moore

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Leaching process as the first stage of hydrometallurgy is a multidisciplinary system including material properties, chemistry, reactor design, mechanics and fluid dynamics. Therefore, doing leaching system optimization by pure scientific methods need lots of times and expenses. In this work, a mixture of two titanium ores and one titanium slag are used for extracting titanium for leaching stage of TiO2 pigment production procedure. Optimum titanium extraction can be obtained from following strategies: i) Maximizing titanium extraction without selective digestion; and ii) Optimizing selective titanium extraction by balancing between maximum titanium extraction and minimum impurity digestion. The main difference between two strategies is due to process optimization framework. For the first strategy, the most important stage of production process is concerned as the main stage and rest of stages would be adopted with respect to the main stage. The second strategy optimizes performance of more than one stage at once. The second strategy has more technical complexity compared to the first one but it brings more economical and technical advantages for the leaching system. Obviously, each strategy has its own optimum operational zone that is not as same as the other one and the best operational zone is chosen due to complexity, economical and practical aspects of the leaching system. Experimental design has been carried out by using Taguchi method. The most important advantages of this methodology are involving different technical aspects of leaching process; minimizing the number of needed experiments as well as time and expense; and concerning the role of parameter interactions due to principles of multifactor-at-time optimization. Leaching tests have been done at batch scale on lab with appropriate control on temperature. The leaching tank geometry has been concerned as an important factor to provide comparable agitation conditions. Data analysis has been done by using reactor design and mass balancing principles. Finally, optimum zone for operational parameters are determined for each leaching strategy and discussed due to their economical and practical aspects.

Keywords: titanium leaching, optimization, experimental design, performance analysis

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86 Identifying Indicative Health Behaviours and Psychosocial Factors Affecting Multi-morbidity Conditions in Ageing Populations: Preliminary Results from the ELSA study of Ageing

Authors: Briony Gray, Glenn Simpson, Hajira Dambha-Miller, Andrew Farmer

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Multimorbidity may be strongly affected by a variety of conditions, factors, and variables requiring higher demands on health and social care services, infrastructure, and expenses. Holding one or more conditions increases one’s risk for development of future conditions; with patients over 65 years old at highest risk. Psychosocial factors such as anxiety and depression are rising exponentially globally, which has been amplified by the COVID19 pandemic. These are highly correlated and predict poorer outcomes when held in coexistence and increase the likelihood of comorbid physical health conditions. While possible future reform of social and healthcare systems may help to alleviate some of these mounting pressures, there remains an urgent need to better understand the potential role health behaviours and psychosocial conditions - such as anxiety and depression – may have on aging populations. Using the UK healthcare scene as a lens for analysis, this study uses big data collected in the UK Longitudinal Study of Aging (ELSA) to examine the role of anxiety and depression in ageing populations (65yrs+). Using logistic regression modelling, results identify the 10 most significant variables correlated with both anxiety and depression from data categorised into the areas of health behaviour, psychosocial, socioeconomic, and life satisfaction (each demonstrated through literature review to be of significance). These are compared with wider global research findings with the aim of better understanding the areas in which social and healthcare reform can support multimorbidity interventions, making suggestions for improved patient-centred care. Scope of future research is outlined, which includes analysis of 59 total multimorbidity variables from the ELSA dataset, going beyond anxiety and depression.

Keywords: multimorbidity, health behaviours, patient centred care, psychosocial factors

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85 Enhancing Project Success: A Case Study of Investment Strategies and Planning Practices in Rwanda’s Housing Projects Managed by Rwanda Social Security Board

Authors: Amina Umulisa

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Background: Despite efforts to enhance profitability and project planning, Rwanda has experienced a decline in project success rates, notably in housing projects managed by the Rwanda Social Security Board (RSSB). This study aims to assess the impact of investment strategies and project planning practices on the performance of pension funds projects in Rwanda, focusing on housing projects by RSSB. Methods: Using descriptive and correlational research designs, this study surveyed 109 randomly selected respondents from a pool of 148 workers. Data analysis was conducted using descriptive and inferential statistics in STATA version 18. Results: Findings revealed that 54% of respondents acknowledged the importance of personnel generation. Additionally, 61% agreed with the effectiveness of training programs, and 79% supported the cost of human resource utilization. In terms of project management practices, 65.7% could determine when a project needed adjustments, 65.7% agreed with the approved budget, and 73% supported forecasted expenses. Furthermore, 68% agreed with order placement, 76.0% with using the right materials, and 64.4% with defining project scope. The study found significant associations between order placement and project quality outcomes (r=0.711, P-value <0.001), as well as with time management (Pearson was 0.701 and sing was 0.00) and cost management (r=0.885, P-value <0.001). Moreover, project time targets were found to significantly affect quality management (Pearson was 0.798, sing was 0.000), time management, and cost management (r=0.740, P-value <0.001). Conclusion: The findings highlight the positive association between the project implementation stage and quality management, indicating effective project planning practices among senior staff. However, there is a need to enhance project team collaboration and coordination to improve the performance of constructed houses.

Keywords: project success rates, investment strategies, training programs, cost management

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84 Validation of Nutritional Assessment Scores in Prediction of Mortality and Duration of Admission in Elderly, Hospitalized Patients: A Cross-Sectional Study

Authors: Christos Lampropoulos, Maria Konsta, Vicky Dradaki, Irini Dri, Konstantina Panouria, Tamta Sirbilatze, Ifigenia Apostolou, Vaggelis Lambas, Christina Kordali, Georgios Mavras

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Objectives: Malnutrition in hospitalized patients is related to increased morbidity and mortality. The purpose of our study was to compare various nutritional scores in order to detect the most suitable one for assessing the nutritional status of elderly, hospitalized patients and correlate them with mortality and extension of admission duration, due to patients’ critical condition. Methods: Sample population included 150 patients (78 men, 72 women, mean age 80±8.2). Nutritional status was assessed by Mini Nutritional Assessment (MNA full, short-form), Malnutrition Universal Screening Tool (MUST) and short Nutritional Appetite Questionnaire (sNAQ). Sensitivity, specificity, positive and negative predictive values and ROC curves were assessed after adjustment for the cause of current admission, a known prognostic factor according to previously applied multivariate models. Primary endpoints were mortality (from admission until 6 months afterwards) and duration of hospitalization, compared to national guidelines for closed consolidated medical expenses. Results: Concerning mortality, MNA (short-form and full) and SNAQ had similar, low sensitivity (25.8%, 25.8% and 35.5% respectively) while MUST had higher sensitivity (48.4%). In contrast, all the questionnaires had high specificity (94%-97.5%). Short-form MNA and sNAQ had the best positive predictive value (72.7% and 78.6% respectively) whereas all the questionnaires had similar negative predictive value (83.2%-87.5%). MUST had the highest ROC curve (0.83) in contrast to the rest questionnaires (0.73-0.77). With regard to extension of admission duration, all four scores had relatively low sensitivity (48.7%-56.7%), specificity (68.4%-77.6%), positive predictive value (63.1%-69.6%), negative predictive value (61%-63%) and ROC curve (0.67-0.69). Conclusion: MUST questionnaire is more advantageous in predicting mortality due to its higher sensitivity and ROC curve. None of the nutritional scores is suitable for prediction of extended hospitalization.

Keywords: duration of admission, malnutrition, nutritional assessment scores, prognostic factors for mortality

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83 Prevalence of Dengue in Sickle Cell Disease in Pre-school Children

Authors: Nikhil A. Gavhane, Sachin Shah, Ishant S. Mahajan, Pawan D. Bahekar

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Introduction: Millions of people are affected with dengue fever every year, which drives up healthcare expenses in many low-income countries. Organ failure and other serious symptoms may result. Another worldwide public health problem is sickle cell anaemia, which is most prevalent in Africa, the Caribbean, and Europe. Dengue epidemics have reportedly occurred in locations with a high frequency of sickle cell disease, compounding the health problems in these areas. Aims and Objectives: This study examines dengue infection in sickle cell disease-afflicted pre-schoolers. Method:This Retrospective cohort study examined paediatric patients. Young people with sickle cell disease (SCD), dengue infection, and a control group without SCD or dengue were studied. Data on demographics, SCD consequences, medical treatments, and laboratory findings were gathered to analyse the influence of SCD on dengue severity and clinical outcomes, classified as severe or non-severe by the 2009 WHO classification. Using fever or admission symptoms, the research estimated acute illness duration. Result: Table 1 compares haemoglobin genotype-based dengue episode features in SS, SC, and controls. Table 2 shows that severe dengue cases are older, have longer admission delays, and have particular symptoms. Table 3's multivariate analysis indicates SS genotype's high connection with severe dengue, multiorgan failure, and acute pulmonary problems. Table 4 relates severe dengue to greater white blood cell counts, anaemia, liver enzymes, and reduced lactate dehydrogenase. Conclusion: This study is valuable but confined to hospitalised dengue patients with sickle cell illness. Small cohorts limit comparisons. Further study is needed since findings contradict predictions.

Keywords: dengue, chills, headache, severe myalgia, vomiting, nausea, prostration

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82 A Cost-Evaluation Study on the Use of Negative Pressure Wound Therapy with Instillation for Salvage of Infected Implant-Based Breast Reconstructions

Authors: S. Haque, M. Kanapathy, E. Bollen, I. Younis, A. Mosahebi

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Background: Implant loss due to infection is the most devastating complication of implant-based breast reconstruction. The use of negative pressure wound therapy with instillation (NPWTi) for salvage of infected implant-based breast reconstructions has shown promising results to allow early reinsertion of a new implant as an alternative to current management of delayed reinsertion. This study compares the cost implication of NPWTi against current management of delayed reinsertion of infected breast implants. Methods: 20 cases of an infected breast implant treated with NPWTi (V.A.C. VERAFLO™ Therapy) followed by early re-insertion of a new implant were compared with 20 cases who had delayed reinsertion (non-NPWTi). Average cost per person was calculated using total operative expenses, cost of inpatient stay, cost of investigations, cost of antibiotics, and cost of outpatient visits. Results: Treatment with NPWTi allowed for earlier re-insertion of a new implant (NPWTi: 9.04 ± 2.92 days vs. non-NPWTi: 236.25 ± 123.89 days). The average cost per patient for NPWTi and non-NPWTi was £14,343.13 ± £2,786.70 and £8,920.31 ± £3,005.73 respectively. All patients treated with NPWTi had one admission and spent 11.9 ± 4.1days as an inpatient while non-NPWTi patients had 2.1 ± 0.3 admissions with total length of inpatient stay of 7.1 ± 5.8days. Patients treated with NPWTi had more surgeries (NPWTi: 3.35 ± 0.81 vs. non-NPWTi: 2.2 ± 0.41), however 3 non-NPWTi cases required flap reconstruction. Patients treated with NPWTi had fewer total outpatient visits (NPWTi: 12 ± 6 vs. non-NPWTi: 14.2 ± 6.3). Conclusion: Patients treated with NPWTi incurred higher average cost per patient, longer inpatient stay, and more procedures; however, had early re-insertion of new implants and fewer admissions and outpatient visits. A further study on patient-reported outcome is essential to compare cost against patient benefit.

Keywords: breast reconstruction, cost evaluation, infection, negative pressure wound therapy

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