Evaluation of world's largest social welfare scheme: An assessment using non-parametric approach.

PubMed

Singh, Sanjeet

2016-08-01

Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) is the world's largest social welfare scheme in India for the poverty alleviation through rural employment generation. This paper aims to evaluate and rank the performance of the states in India under MGNREGA scheme. A non-parametric approach, Data Envelopment Analysis (DEA) is used to calculate the overall technical, pure technical, and scale efficiencies of states in India. The sample data is drawn from the annual official reports published by the Ministry of Rural Development, Government of India. Based on three selected input parameters (expenditure indicators) and five output parameters (employment generation indicators), I apply both input and output oriented DEA models to estimate how well the states utilize their resources and generate outputs during the financial year 2013-14. The relative performance evaluation has been made under the assumption of constant returns and also under variable returns to scale to assess the impact of scale on performance. The results indicate that the main source of inefficiency is both technical and managerial practices adopted. 11 states are overall technically efficient and operate at the optimum scale whereas 18 states are pure technical or managerially efficient. It has been found that for some states it necessary to alter scheme size to perform at par with the best performing states. For inefficient states optimal input and output targets along with the resource savings and output gains are calculated. Analysis shows that if all inefficient states operate at optimal input and output levels, on an average 17.89% of total expenditure and a total amount of $780million could have been saved in a single year. Most of the inefficient states perform poorly when it comes to the participation of women and disadvantaged sections (SC&ST) in the scheme. In order to catch up with the performance of best performing states, inefficient states on an average need to enhance women participation by 133%. In addition, the states are also ranked using the cross efficiency approach and results are analyzed. State of Tamil Nadu occupies the top position followed by Puducherry, Punjab, and Rajasthan in the ranking list. To the best of my knowledge, this is the first pan-India level study to evaluate and rank the performance of MGNREGA scheme quantitatively and so comprehensively. Copyright © 2016 Elsevier Ltd. All rights reserved.

Technical efficiency of peripheral health units in Pujehun district of Sierra Leone: a DEA application

PubMed Central

Renner, Ade; Kirigia, Joses M; Zere, Eyob A; Barry, Saidou P; Kirigia, Doris G; Kamara, Clifford; Muthuri, Lenity HK

2005-01-01

Background The Data Envelopment Analysis (DEA) method has been fruitfully used in many countries in Asia, Europe and North America to shed light on the efficiency of health facilities and programmes. There is, however, a dearth of such studies in countries in sub-Saharan Africa. Since hospitals and health centres are important instruments in the efforts to scale up pro-poor cost-effective interventions aimed at achieving the United Nations Millennium Development Goals, decision-makers need to ensure that these health facilities provide efficient services. The objective of this study was to measure the technical efficiency (TE) and scale efficiency (SE) of a sample of public peripheral health units (PHUs) in Sierra Leone. Methods This study applied the Data Envelopment Analysis approach to investigate the TE and SE among a sample of 37 PHUs in Sierra Leone. Results Twenty-two (59%) of the 37 health units analysed were found to be technically inefficient, with an average score of 63% (standard deviation = 18%). On the other hand, 24 (65%) health units were found to be scale inefficient, with an average scale efficiency score of 72% (standard deviation = 17%). Conclusion It is concluded that with the existing high levels of pure technical and scale inefficiency, scaling up of interventions to achieve both global and regional targets such as the MDG and Abuja health targets becomes far-fetched. In a country with per capita expenditure on health of about US$7, and with only 30% of its population having access to health services, it is demonstrated that efficiency savings can significantly augment the government's initiatives to cater for the unmet health care needs of the population. Therefore, we strongly recommend that Sierra Leone and all other countries in the Region should institutionalise health facility efficiency monitoring at the Ministry of Health headquarter (MoH/HQ) and at each health district headquarter. PMID:16354299

Does multi-functionality affect technical efficiency? A non-parametric analysis of the Scottish dairy industry.

PubMed

Barnes, A P

2006-09-01

Recent policy changes within the Common Agricultural Policy have led to a shift from a solely production-led agriculture towards the promotion of multi-functionality. Conversely, the removal of production-led supports would indicate that an increased concentration on production efficiencies would seem a critical strategy for a country's future competitiveness. This paper explores the relationship between the 'multi-functional' farming attitude desired by policy makers and its effect on technical efficiency within Scottish dairy farming. Technical efficiency scores are calculated by applying the non-parametric data envelopment analysis technique and then measured against causes of inefficiency. Amongst these explanatory factors is a constructed score of multi-functionality. This research finds that, amongst other factors, a multi-functional attitude has a significant positive effect on technical efficiency. Consequently, this seems to validate the promotion of a multi-functional approach to farming currently being championed by policy-makers.

Technical and scale efficiency of public community hospitals in Eritrea: an exploratory study

PubMed Central

2013-01-01

Background Eritrean gross national income of Int$610 per capita is lower than the average for Africa (Int$1620) and considerably lower than the global average (Int$6977). It is therefore imperative that the country’s resources, including those specifically allocated to the health sector, are put to optimal use. The objectives of this study were (a) to estimate the relative technical and scale efficiency of public secondary level community hospitals in Eritrea, based on data generated in 2007, (b) to estimate the magnitudes of output increases and/or input reductions that would have been required to make relatively inefficient hospitals more efficient, and (c) to estimate using Tobit regression analysis the impact of institutional and contextual/environmental variables on hospital inefficiencies. Methods A two-stage Data Envelopment Analysis (DEA) method is used to estimate efficiency of hospitals and to explain the inefficiencies. In the first stage, the efficient frontier and the hospital-level efficiency scores are first estimated using DEA. In the second stage, the estimated DEA efficiency scores are regressed on some institutional and contextual/environmental variables using a Tobit model. In 2007 there were a total of 20 secondary public community hospitals in Eritrea, nineteen of which generated data that could be included in the study. The input and output data were obtained from the Ministry of Health (MOH) annual health service activity report of 2007. Since our study employs data that are five years old, the results are not meant to uncritically inform current decision-making processes, but rather to illustrate the potential value of such efficiency analyses. Results The key findings were as follows: (i) the average constant returns to scale technical efficiency score was 90.3%; (ii) the average variable returns to scale technical efficiency score was 96.9%; and (iii) the average scale efficiency score was 93.3%. In 2007, the inefficient hospitals could have become more efficient by either increasing their outputs by 20,611 outpatient visits and 1,806 hospital discharges, or by transferring the excess 2.478 doctors (2.85%), 9.914 nurses and midwives (0.98%), 9.774 laboratory technicians (9.68%), and 195 beds (10.42%) to primary care facilities such as health centres, health stations, and maternal and child health clinics. In the Tobit regression analysis, the coefficient for OPDIPD (outpatient visits as a proportion of inpatient days) had a negative sign, and was statistically significant; and the coefficient for ALOS (average length of stay) had a positive sign, and was statistically significant at 5% level of significance. Conclusions The findings from the first-stage analysis imply that 68% hospitals were variable returns to scale technically efficient; and only 42% hospitals achieved scale efficiency. On average, inefficient hospitals could have increased their outpatient visits by 5.05% and hospital discharges by 3.42% using the same resources. Our second-stage analysis shows that the ratio of outpatient visits to inpatient days and average length of inpatient stay are significantly correlated with hospital inefficiencies. This study shows that routinely collected hospital data in Eritrea can be used to identify relatively inefficient hospitals as well as the sources of their inefficiencies. PMID:23497525

A stochastic frontier analysis of technical efficiency of fish cage culture in Peninsular Malaysia.

PubMed

Islam, Gazi Md Nurul; Tai, Shzee Yew; Kusairi, Mohd Noh

2016-01-01

Cage culture plays an important role in achieving higher output and generating more export earnings in Malaysia. However, the cost of fingerlings, feed and labour have increased substantially for cage culture in the coastal areas in Peninsular Malaysia. This paper uses farm level data gathered from Manjung, Perak and Kota Tinggi, Johor to investigate the technical efficiency of brackish water fish cage culture using the stochastic frontier approach. The technical efficiency was estimated and specifically the factors affecting technical inefficiencies of fish cage culture system in Malaysia was investigated. On average, 37 percent of the sampled fish cage farms are technically efficient. The results suggest very high degrees of technical inefficiency exist among the cage culturists. This implies that great potential exists to increase fish production through improved efficiency in cage culture management in Peninsular Malaysia. The results indicate that farmers obtained grouper fingerlings from other neighboring countries due to scarcity of fingerlings from wild sources. The cost of feeding for grouper (Epinephelus fuscoguttatus) requires relatively higher costs compared to seabass (Lates calcarifer) production in cage farms in the study areas. Initiatives to undertake extension programmes at the farm level are needed to help cage culturists in utilizing their resources more efficiently in order to substantially enhance their fish production.

The Method of Validity Evaluation of Hard Coal Excavation in Residual Seam Parts

NASA Astrophysics Data System (ADS)

Wodarski, Krzysztof; Bijańska, Jolanta; Gumiński, Adam

2017-12-01

The excavation of residual seam parts should be justified by positive assessment of the purposefulness, technical feasibility and economic effectiveness. The results of the profitability evaluation are crucial in a decision making process. The excavation of residual seam parts, even if it is possible from a technical point of view, should not be implemented if it is economically inefficient or when accompanied by a very high risk of non-recovery of invested capital resources. The article presents the evaluation method of possibilities of excavating hard coal from residual seam parts, and the example of its use in one of collieries in the Upper Silesian Coal Basin. Working in line with the developed method, allows to indicate the variant of residual seam part exploitation, which is feasible to implement from a technical point of view, and which is characterized by the highest economic effectiveness and lowest risk.

Assessment of productivity of hospitals in Botswana: a DEA application.

PubMed

Tlotlego, Naomi; Nonvignon, Justice; Sambo, Luis G; Asbu, Eyob Z; Kirigia, Joses M

2010-11-05

Botswana national health policy states that the Ministry of Health shall from time to time review and revise its organization and management structures to respond to new developments and challenges in order to achieve and sustain a high level of efficiency in the provision of health care. Even though the government clearly views assuring efficiency in the health sector as one of its leadership and governance responsibilities, to date no study has been undertaken to measure the technical efficiency of hospitals which consume the majority of health sector resources. The specific objectives of this study were to quantify the technical and scale efficiency of hospitals in Botswana, and to evaluate changes in productivity over a three year period in order to analyze changes in efficiency and technology use. DEAP software was used to analyze technical efficiency along with the DEA-based Malmquist productivity index which was applied to a sample of 21 non-teaching hospitals in the Republic of Botswana over a period of three years (2006 to 2008). The analysis revealed that 16 (76.2 percent), 16 (76.2 percent) and 13 (61.9 percent) of the 21 hospitals were run inefficiently in 2006, 2007 and 2008, with average variable returns to scale (VRS) technical efficiency scores of 70.4 percent, 74.2 percent and 76.3 percent respectively. On average, Malmquist Total Factor Productivity (MTFP) decreased by 1.5 percent. Whilst hospital efficiency increased by 3.1 percent, technical change (innovation) regressed by 4.5 percent. Efficiency change was thus attributed to an improvement in pure efficiency of 4.2 percent and a decline in scale efficiency of 1 percent. The MTFP change was the highest in 2008 (MTFP = 1.008) and the lowest in 2007 (MTFP = 0.963). The results indicate significant inefficiencies within the sample for the years under study. In 2008, taken together, the inefficient hospitals would have needed to increase the number of outpatient visits by 117627 (18 percent) and inpatient days by 49415 (13 percent) in order to reach full efficiency. Alternatively, inefficiencies could have been reduced by transferring 264 clinical staff and 39 beds to health clinics, health posts and mobile posts. The transfer of excess clinical staff to those facilities which are closest to the communities may also contribute to accelerating progress towards the Millennium Development Goals related to child and maternal health.Nine (57.1 percent) of the 21 hospitals experienced MTFP deterioration during the three years. We found the sources of inefficiencies to be either adverse change in pure efficiency, scale efficiency and/or technical efficiency.In line with the report Health financing: A strategy for the African Region, which was adopted by the Fifty-sixth WHO Regional Committee for Africa, it might be helpful for Botswana to consider institutionalizing efficiency monitoring of health facilities within health management information systems.

Technical Efficiency and Primary Education in South Africa: Evidence from Sub-National Level Analyses

ERIC Educational Resources Information Center

Boateng, Nana Adowaa

2014-01-01

The paper examines the extent to which sub-national public officials are efficient in delivering basic education services and argues that technical inefficiencies, especially in the management of public funds for education, could potentially contribute to poor education service delivery in South Africa. A conceptual framework is proposed to show…

Scaling production and improving efficiency in DEA: an interactive approach

NASA Astrophysics Data System (ADS)

Rödder, Wilhelm; Kleine, Andreas; Dellnitz, Andreas

2017-10-01

DEA models help a DMU to detect its (in-)efficiency and to improve activities, if necessary. Efficiency is only one economic aim for a decision-maker; however, up- or downsizing might be a second one. Improving efficiency is the main topic in DEA; the long-term strategy towards the right production size should attract our attention as well. Not always the management of a DMU primarily focuses on technical efficiency but rather is interested in gaining scale effects. In this paper, a formula for returns to scale (RTS) is developed, and this formula is even applicable for interior points of technology. Particularly, technical and scale inefficient DMUs need sophisticated instruments to improve their situation. Considering RTS as well as efficiency, in this paper, we give an advice for each DMU to find an economically reliable path from its actual situation to better activities and finally to most productive scale size (mpss), perhaps. For realizing this path, we propose an interactive algorithm, thus harmonizing the scientific findings and the interests of the management. Small numerical examples illustrate such paths for selected DMUs; an empirical application in theatre management completes the contribution.

Ownership and technical efficiency of hospitals: evidence from Ghana using data envelopment analysis.

PubMed

Jehu-Appiah, Caroline; Sekidde, Serufusa; Adjuik, Martin; Akazili, James; Almeida, Selassi D; Nyonator, Frank; Baltussen, Rob; Asbu, Eyob Zere; Kirigia, Joses Muthuri

2014-04-08

In order to measure and analyse the technical efficiency of district hospitals in Ghana, the specific objectives of this study were to (a) estimate the relative technical and scale efficiency of government, mission, private and quasi-government district hospitals in Ghana in 2005; (b) estimate the magnitudes of output increases and/or input reductions that would have been required to make relatively inefficient hospitals more efficient; and (c) use Tobit regression analysis to estimate the impact of ownership on hospital efficiency. In the first stage, we used data envelopment analysis (DEA) to estimate the efficiency of 128 hospitals comprising of 73 government hospitals, 42 mission hospitals, 7 quasi-government hospitals and 6 private hospitals. In the second stage, the estimated DEA efficiency scores are regressed against hospital ownership variable using a Tobit model. This was a retrospective study. In our DEA analysis, using the variable returns to scale model, out of 128 district hospitals, 31 (24.0%) were 100% efficient, 25 (19.5%) were very close to being efficient with efficiency scores ranging from 70% to 99.9% and 71 (56.2%) had efficiency scores below 50%. The lowest-performing hospitals had efficiency scores ranging from 21% to 30%.Quasi-government hospitals had the highest mean efficiency score (83.9%) followed by public hospitals (70.4%), mission hospitals (68.6%) and private hospitals (55.8%). However, public hospitals also got the lowest mean technical efficiency scores (27.4%), implying they have some of the most inefficient hospitals.Regarding regional performance, Northern region hospitals had the highest mean efficiency score (83.0%) and Volta Region hospitals had the lowest mean score (43.0%).From our Tobit regression, we found out that while quasi-government ownership is positively associated with hospital technical efficiency, private ownership negatively affects hospital efficiency. It would be prudent for policy-makers to examine the least efficient hospitals to correct widespread inefficiency. This would include reconsidering the number of hospitals and their distribution, improving efficiency and reducing duplication by closing or scaling down hospitals with efficiency scores below a certain threshold. For private hospitals with inefficiency related to large size, there is a need to break down such hospitals into manageable sizes.

Ownership and technical efficiency of hospitals: evidence from Ghana using data envelopment analysis

PubMed Central

2014-01-01

Background In order to measure and analyse the technical efficiency of district hospitals in Ghana, the specific objectives of this study were to (a) estimate the relative technical and scale efficiency of government, mission, private and quasi-government district hospitals in Ghana in 2005; (b) estimate the magnitudes of output increases and/or input reductions that would have been required to make relatively inefficient hospitals more efficient; and (c) use Tobit regression analysis to estimate the impact of ownership on hospital efficiency. Methods In the first stage, we used data envelopment analysis (DEA) to estimate the efficiency of 128 hospitals comprising of 73 government hospitals, 42 mission hospitals, 7 quasi-government hospitals and 6 private hospitals. In the second stage, the estimated DEA efficiency scores are regressed against hospital ownership variable using a Tobit model. This was a retrospective study. Results In our DEA analysis, using the variable returns to scale model, out of 128 district hospitals, 31 (24.0%) were 100% efficient, 25 (19.5%) were very close to being efficient with efficiency scores ranging from 70% to 99.9% and 71 (56.2%) had efficiency scores below 50%. The lowest-performing hospitals had efficiency scores ranging from 21% to 30%. Quasi-government hospitals had the highest mean efficiency score (83.9%) followed by public hospitals (70.4%), mission hospitals (68.6%) and private hospitals (55.8%). However, public hospitals also got the lowest mean technical efficiency scores (27.4%), implying they have some of the most inefficient hospitals. Regarding regional performance, Northern region hospitals had the highest mean efficiency score (83.0%) and Volta Region hospitals had the lowest mean score (43.0%). From our Tobit regression, we found out that while quasi-government ownership is positively associated with hospital technical efficiency, private ownership negatively affects hospital efficiency. Conclusions It would be prudent for policy-makers to examine the least efficient hospitals to correct widespread inefficiency. This would include reconsidering the number of hospitals and their distribution, improving efficiency and reducing duplication by closing or scaling down hospitals with efficiency scores below a certain threshold. For private hospitals with inefficiency related to large size, there is a need to break down such hospitals into manageable sizes. PMID:24708886

Scientific and Technical Serials Holdings Optimization in an Inefficient Market: A LSU Serials Redesign Project Exercise.

ERIC Educational Resources Information Center

Bensman, Stephen J.; Wilder, Stanley J.

1998-01-01

Analyzes the structure of the library market for scientific and technical (ST) serials. Describes an exercise aimed at a theoretical reconstruction of the ST-serials holdings of Louisiana State University (LSU) Libraries. Discusses the set definitions, measures, and algorithms necessary in the design of a computer program to appraise ST serials.…

Financial performance monitoring of the technical efficiency of critical access hospitals: a data envelopment analysis and logistic regression modeling approach.

PubMed

Wilson, Asa B; Kerr, Bernard J; Bastian, Nathaniel D; Fulton, Lawrence V

2012-01-01

From 1980 to 1999, rural designated hospitals closed at a disproportionally high rate. In response to this emergent threat to healthcare access in rural settings, the Balanced Budget Act of 1997 made provisions for the creation of a new rural hospital--the critical access hospital (CAH). The conversion to CAH and the associated cost-based reimbursement scheme significantly slowed the closure rate of rural hospitals. This work investigates which methods can ensure the long-term viability of small hospitals. This article uses a two-step design to focus on a hypothesized relationship between technical efficiency of CAHs and a recently developed set of financial monitors for these entities. The goal is to identify the financial performance measures associated with efficiency. The first step uses data envelopment analysis (DEA) to differentiate efficient from inefficient facilities within a data set of 183 CAHs. Determining DEA efficiency is an a priori categorization of hospitals in the data set as efficient or inefficient. In the second step, DEA efficiency is the categorical dependent variable (efficient = 0, inefficient = 1) in the subsequent binary logistic regression (LR) model. A set of six financial monitors selected from the array of 20 measures were the LR independent variables. We use a binary LR to test the null hypothesis that recently developed CAH financial indicators had no predictive value for categorizing a CAH as efficient or inefficient, (i.e., there is no relationship between DEA efficiency and fiscal performance).

A stochastic frontier approach to study the relationship between gastrointestinal nematode infections and technical efficiency of dairy farms.

PubMed

van der Voort, Mariska; Van Meensel, Jef; Lauwers, Ludwig; Vercruysse, Jozef; Van Huylenbroeck, Guido; Charlier, Johannes

2014-01-01

The impact of gastrointestinal (GI) nematode infections in dairy farming has traditionally been assessed using partial productivity indicators. But such approaches ignore the impact of infection on the performance of the whole farm. In this study, efficiency analysis was used to study the association of the GI nematode Ostertagia ostertagi on the technical efficiency of dairy farms. Five years of accountancy data were linked to GI nematode infection data gained from a longitudinal parasitic monitoring campaign. The level of exposure to GI nematodes was based on bulk-tank milk ELISA tests, which measure the antibodies to O. ostertagi and was expressed as an optical density ratio (ODR). Two unbalanced data panels were created for the period 2006 to 2010. The first data panel contained 198 observations from the Belgian Farm Accountancy Data Network (Brussels, Belgium) and the second contained 622 observations from the Boerenbond Flemish farmers' union (Leuven, Belgium) accountancy system (Tiber Farm Accounting System). We used the stochastic frontier analysis approach and defined inefficiency effect models specified with the Cobb-Douglas and transcendental logarithmic (Translog) functional form. To assess the efficiency scores, milk production was considered as the main output variable. Six input variables were used: concentrates, roughage, pasture, number of dairy cows, animal health costs, and labor. The ODR of each individual farm served as an explanatory variable of inefficiency. An increase in the level of exposure to GI nematodes was associated with a decrease in technical efficiency. Exposure to GI nematodes constrains the productivity of pasture, health, and labor but does not cause inefficiency in the use of concentrates, roughage, and dairy cows. Lowering the level of infection in the interquartile range (0.271 ODR) was associated with an average milk production increase of 27, 19, and 9L/cow per year for Farm Accountancy Data Network farms and 63, 49, and 23L/cow per year for Tiber Farm Accounting System farms in the low- (0-90), medium- (90-95), and high- (95-99) efficiency score groups, respectively. The potential milk increase associated with reducing the level of infection was higher for highly efficient farms (6.7% of the total possible milk increase when becoming fully technically efficient) than for less efficient farms (3.8% of the total possible milk increase when becoming fully technically efficient). Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Libman, George H.; Doerry, Armin Walter

Brief disclosures may often be sufficient for the filing of a Technical Advance with Sandia's Intellectual Property Center, but still be inadequate to facilitate an optimum patent application where more detail and explanation are required. Consequently, the crafting of a patent application may require considerably more additional interaction between the application preparer and the inventors. This inefficiency can be considerably mitigated if the inventors address some critical aspects of a patent application when they write a technical report.

Does integration of HIV and sexual and reproductive health services improve technical efficiency in Kenya and Swaziland? An application of a two-stage semi parametric approach incorporating quality measures

PubMed Central

Obure, Carol Dayo; Jacobs, Rowena; Guinness, Lorna; Mayhew, Susannah; Vassall, Anna

2016-01-01

Theoretically, integration of vertically organized services is seen as an important approach to improving the efficiency of health service delivery. However, there is a dearth of evidence on the effect of integration on the technical efficiency of health service delivery. Furthermore, where technical efficiency has been assessed, there have been few attempts to incorporate quality measures within efficiency measurement models particularly in sub-Saharan African settings. This paper investigates the technical efficiency and the determinants of technical efficiency of integrated HIV and sexual and reproductive health (SRH) services using data collected from 40 health facilities in Kenya and Swaziland for 2008/2009 and 2010/2011. Incorporating a measure of quality, we estimate the technical efficiency of health facilities and explore the effect of integration and other environmental factors on technical efficiency using a two-stage semi-parametric double bootstrap approach. The empirical results reveal a high degree of inefficiency in the health facilities studied. The mean bias corrected technical efficiency scores taking quality into consideration varied between 22% and 65% depending on the data envelopment analysis (DEA) model specification. The number of additional HIV services in the maternal and child health unit, public ownership and facility type, have a positive and significant effect on technical efficiency. However, number of additional HIV and STI services provided in the same clinical room, proportion of clinical staff to overall staff, proportion of HIV services provided, and rural location had a negative and significant effect on technical efficiency. The low estimates of technical efficiency and mixed effects of the measures of integration on efficiency challenge the notion that integration of HIV and SRH services may substantially improve the technical efficiency of health facilities. The analysis of quality and efficiency as separate dimensions of performance suggest that efficiency may be achieved without sacrificing quality. PMID:26803655

Does integration of HIV and sexual and reproductive health services improve technical efficiency in Kenya and Swaziland? An application of a two-stage semi parametric approach incorporating quality measures.

PubMed

Obure, Carol Dayo; Jacobs, Rowena; Guinness, Lorna; Mayhew, Susannah; Vassall, Anna

2016-02-01

Theoretically, integration of vertically organized services is seen as an important approach to improving the efficiency of health service delivery. However, there is a dearth of evidence on the effect of integration on the technical efficiency of health service delivery. Furthermore, where technical efficiency has been assessed, there have been few attempts to incorporate quality measures within efficiency measurement models particularly in sub-Saharan African settings. This paper investigates the technical efficiency and the determinants of technical efficiency of integrated HIV and sexual and reproductive health (SRH) services using data collected from 40 health facilities in Kenya and Swaziland for 2008/2009 and 2010/2011. Incorporating a measure of quality, we estimate the technical efficiency of health facilities and explore the effect of integration and other environmental factors on technical efficiency using a two-stage semi-parametric double bootstrap approach. The empirical results reveal a high degree of inefficiency in the health facilities studied. The mean bias corrected technical efficiency scores taking quality into consideration varied between 22% and 65% depending on the data envelopment analysis (DEA) model specification. The number of additional HIV services in the maternal and child health unit, public ownership and facility type, have a positive and significant effect on technical efficiency. However, number of additional HIV and STI services provided in the same clinical room, proportion of clinical staff to overall staff, proportion of HIV services provided, and rural location had a negative and significant effect on technical efficiency. The low estimates of technical efficiency and mixed effects of the measures of integration on efficiency challenge the notion that integration of HIV and SRH services may substantially improve the technical efficiency of health facilities. The analysis of quality and efficiency as separate dimensions of performance suggest that efficiency may be achieved without sacrificing quality. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Relative performance of academic departments using DEA with sensitivity analysis.

PubMed

Tyagi, Preeti; Yadav, Shiv Prasad; Singh, S P

2009-05-01

The process of liberalization and globalization of Indian economy has brought new opportunities and challenges in all areas of human endeavor including education. Educational institutions have to adopt new strategies to make best use of the opportunities and counter the challenges. One of these challenges is how to assess the performance of academic programs based on multiple criteria. Keeping this in view, this paper attempts to evaluate the performance efficiencies of 19 academic departments of IIT Roorkee (India) through data envelopment analysis (DEA) technique. The technique has been used to assess the performance of academic institutions in a number of countries like USA, UK, Australia, etc. But we are using it first time in Indian context to the best of our knowledge. Applying DEA models, we calculate technical, pure technical and scale efficiencies and identify the reference sets for inefficient departments. Input and output projections are also suggested for inefficient departments to reach the frontier. Overall performance, research performance and teaching performance are assessed separately using sensitivity analysis.

Clinical review: Humidifiers during non-invasive ventilation - key topics and practical implications

PubMed Central

2012-01-01

Inadequate gas conditioning during non-invasive ventilation (NIV) can impair the anatomy and function of nasal mucosa. The resulting symptoms may have a negative effect on patients' adherence to ventilatory treatment, especially for chronic use. Several parameters, mostly technical aspects of NIV, contribute to inefficient gas conditioning. Factors affecting airway humidity during NIV include inspiratory flow, inspiratory oxygen fraction, leaks, type of ventilator, interface used to deliver NIV, temperature and pressure of inhaled gas, and type of humidifier. The correct application of a humidification system may avoid the effects of NIV-induced drying of the airway. This brief review analyses the consequences of airway dryness in patients receiving NIV and the technical tools necessary to guarantee adequate gas conditioning during ventilatory treatment. Open questions remain about the timing of gas conditioning for acute or chronic settings, the choice and type of humidification device, the interaction between the humidifier and the underlying disease, and the effects of individual humidification systems on delivered humidity. PMID:22316078

The Technical Efficiency of Specialised Milk Farms: A Regional View

PubMed Central

Špička, Jindřich; Smutka, Luboš

2014-01-01

The aim of the article is to evaluate production efficiency and its determinants of specialised dairy farming among the EU regions. In the most of European regions, there is a relatively high significance of small specialised farms including dairy farms. The DEAVRS method (data envelopment analysis with variable returns to scale) reveals efficient and inefficient regions including the scale efficiency. In the next step, the two-sample t-test determines differences of economic and structural indicators between efficient and inefficient regions. The research reveals that substitution of labour by capital/contract work explains the variability of the farm net value added per AWU (annual work unit) income indicator by more than 30%. The significant economic determinants of production efficiency in specialised dairy farming are farm size, herd size, crop output per hectare, productivity of energy, and capital (at α = 0.01). Specialised dairy farms in efficient regions have significantly higher farm net value added per AWU than inefficient regions. Agricultural enterprises in inefficient regions have a more extensive structure and produce more noncommodity output (public goods). Specialised dairy farms in efficient regions have a slightly higher milk yield, specific livestock costs of feed, bedding, and veterinary services per livestock unit. PMID:25050408

[Impact of the funding reform of teaching hospitals in Brazil].

PubMed

Lobo, M S C; Silva, A C M; Lins, M P E; Fiszman, R

2009-06-01

To assess the impact of funding reform on the productivity of teaching hospitals. Based on the Information System of Federal University Hospitals of Brazil, 2003 and 2006 efficiency and productivity were measured using frontier methods with a linear programming technique, data envelopment analysis, and input-oriented variable returns to scale model. The Malmquist index was calculated to detect changes during the study period: 'technical efficiency change,' or the relative variation of the efficiency of each unit; and 'technological change' after frontier shift. There was 51% mean budget increase and improvement of technical efficiency of teaching hospitals (previously 11, 17 hospitals reached the empirical efficiency frontier) but the same was not seen for the technology frontier. Data envelopment analysis set benchmark scores for each inefficient unit (before and after reform) and there was a positive correlation between technical efficiency and teaching intensity and dedication. The reform promoted management improvements but there is a need of further follow-up to assess the effectiveness of funding changes.

Environmental impact assessment in urban transport planning: Exploring process-related barriers in Spanish practice

DOE Office of Scientific and Technical Information (OSTI.GOV)

Soria-Lara, Julio A., E-mail: j.a.sorialara@uva.nl; Bertolini, Luca, E-mail: l.bertolini@uva.nl; Brömmelstroet, Marco te, E-mail: M.C.G.teBrommelstroet@uva.nl

The effectiveness of EIA for evaluating transport planning projects is increasingly being questioned by practitioners, institutions and scholars. The academic literature has traditionally focused more on solving content-related problems with EIA (i.e. the measurement of environmental effects) than on process-related issues (i.e. the role of EIA in the planning process and the interaction between key actors). Focusing only on technical improvements is not sufficient for rectifying the effectiveness problems of EIA. In order to address this knowledge gap, the paper explores how EIA is experienced in the Spanish planning context and offers in-depth insight into EIA process-related issues in themore » field of urban transport planning. From the multitude of involved actors, the research focuses on exploring the perceptions of the two main professional groups: EIA developers and transport planners. Through a web-based survey we assess the importance of process-related barriers to the effective use of EIA in urban transport planning. The analyses revealed process issues based fundamentally on unstructured stakeholders involvement and an inefficient public participation - Highlights: • Qualitative research on perceptions of EIA participants on EIA processes. • Web-based survey with different participants (EIA-developers; transport planners). • It was seen an inefficient participation of stakeholders during the EIA processes.« less

78 FR 75571 - Independent Assessment of the Process for the Review of Device Submissions; High Priority...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-12

... of performing the technical analysis, management assessment, and program evaluation tasks required to.... Analysis of elements of the review process (including the presubmission process, and investigational device... time to facilitate a more efficient process. This includes analysis of root causes for inefficiencies...

Benchmarking organ procurement organizations: a national study.

PubMed Central

Ozcan, Y A; Begun, J W; McKinney, M M

1999-01-01

OBJECTIVE: An exploratory examination of the technical efficiency of organ procurement organizations (OPOs) relative to optimal patterns of production in the population of OPOs in the United States. DATA SOURCES: A composite data set with the OPO as the unit of analysis, constructed from a 1995 national survey of OPOs (n = 64), plus secondary data from the Association of Organ Procurement Organizations and the United Network for Organ Sharing. STUDY DESIGN: The study uses data envelopment analysis (DEA) to evaluate the technical efficiency of all OPOs. PRINCIPAL FINDINGS: Overall, six of the 22 larger OPOs (27 percent) are classified as inefficient, while 23 of the 42 smaller OPOs (55 percent) are classified as inefficient. Efficient OPOs recover significantly more kidneys and extrarenal organs; have higher operating expenses; and have more referrals, donors, extrarenal transplants, and kidney transplants. The quantities of hospital development personnel and other personnel, and formalization of hospital development activities in both small and large OPOs, do not significantly differ. CONCLUSIONS: Indications that larger OPOs are able to operate more efficiently relative to their peers suggest that smaller OPOs are more likely to benefit from technical assistance. More detailed information on the activities of OPO staff would help pinpoint activities that can increase OPO efficiency and referrals, and potentially improve outcomes for large numbers of patients awaiting transplants. PMID:10536974

Climate change adaptation: a panacea for food security in Ondo State, Nigeria

NASA Astrophysics Data System (ADS)

Fatuase, A. I.

2017-08-01

This paper examines the likely perceived causes of climate change, adaptation strategies employed and technical inefficiency of arable crop farmers in Ondo State, Nigeria. Data were obtained from primary sources using a set of structured questionnaire assisted with interview schedule. Multistage sampling technique was used. Data were analyzed using the following: descriptive statistics and the stochastic frontier production function. The findings showed that majority of the respondents (59.1 %) still believed that climate change is a natural phenomenon that is beyond man's power to abate while industrial release, improper sewage disposal, fossil fuel use, deforestation and bush burning were perceived as the most human factors that influence climate change by the category that chose human activities (40.9 %) as the main causes of climate change. The main employed adaptation strategies by the farmers were mixed cropping, planting early matured crop, planting of resistant crops and use of agrochemicals. The arable crop farmers were relatively technically efficient with about 53 % of them having technical efficiency above the average of 0.784 for the study area. The study observed that education, adaptation, perception, climate information and farming experience were statistically significant in decreasing inefficiency of arable crop production. Therefore, advocacy on climate change and its adaptation strategies should be intensified in the study area.

77 FR 75173 - Comprehensive Assessment of the Process for the Review of Device Submissions; Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-19

... performing the technical analysis, management assessment, and program evaluation tasks required to address... premarket reviews that meet regulatory review standards. 2. Analysis of elements of the review process... process. This includes analysis of root causes for inefficiencies that may affect review performance and...

Cost Efficiency in the University: A Departmental Evaluation Model

ERIC Educational Resources Information Center

Gimenez, Victor M.; Martinez, Jose Luis

2006-01-01

This article presents a model for the analysis of cost efficiency within the framework of data envelopment analysis models. It calculates the cost excess, separating a unit of production from its optimal or frontier levels, and, at the same time, breaks these excesses down into three explanatory factors: (a) technical inefficiency, which depends…

An Estimation of Technical Efficiency for Florida Public Elementary Schools

ERIC Educational Resources Information Center

Conroy, Stephen J.; Arguea, Nestor M.

2008-01-01

We use a frontier production function estimation technique to analyze whether elementary schools in Florida are operating at an efficient level and to explain any inefficiencies. A motivation for this analysis comes from recent state and federal level educational initiatives designed to improve school accountability and reduce class sizes. Results…

A study of the talent training project management for semiconductor industry in Taiwan: the application of a hybrid data envelopment analysis approach.

PubMed

Kao, Ling-Jing; Chiu, Shu-Yu; Ko, Hsien-Tang

2014-01-01

The purpose of this study is to evaluate the training institution performance and to improve the management of the Manpower Training Project (MTP) administered by the Semiconductor Institute in Taiwan. Much literature assesses the efficiency of an internal training program initiated by a firm, but only little literature studies the efficiency of an external training program led by government. In the study, a hybrid solution of ICA-DEA and ICA-MPI is developed for measuring the efficiency and the productivity growth of each training institution over the period. The technical efficiency change, the technological change, pure technical efficiency change, scale efficiency change, and the total factor productivity change were evaluated according to five inputs and two outputs. According to the results of the study, the training institutions can be classified by their efficiency successfully and the guidelines for the optimal level of input resources can be obtained for each inefficient training institution. The Semiconductor Institute in Taiwan can allocate budget more appropriately and establish withdrawal mechanisms for inefficient training institutions.

A Study of the Talent Training Project Management for Semiconductor Industry in Taiwan: The Application of a Hybrid Data Envelopment Analysis Approach

PubMed Central

Kao, Ling-Jing; Chiu, Shu-Yu; Ko, Hsien-Tang

2014-01-01

The purpose of this study is to evaluate the training institution performance and to improve the management of the Manpower Training Project (MTP) administered by the Semiconductor Institute in Taiwan. Much literature assesses the efficiency of an internal training program initiated by a firm, but only little literature studies the efficiency of an external training program led by government. In the study, a hybrid solution of ICA-DEA and ICA-MPI is developed for measuring the efficiency and the productivity growth of each training institution over the period. The technical efficiency change, the technological change, pure technical efficiency change, scale efficiency change, and the total factor productivity change were evaluated according to five inputs and two outputs. According to the results of the study, the training institutions can be classified by their efficiency successfully and the guidelines for the optimal level of input resources can be obtained for each inefficient training institution. The Semiconductor Institute in Taiwan can allocate budget more appropriately and establish withdrawal mechanisms for inefficient training institutions. PMID:24977192

Air traffic management as principled negotiation between intelligent agents

NASA Technical Reports Server (NTRS)

Wangermann, J. P.

1994-01-01

The major challenge facing the world's aircraft/airspace system (AAS) today is the need to provide increased capacity, while reducing delays, increasing the efficiency of flight operations, and improving safety. Technologies are emerging that should improve the performance of the system, but which could also introduce uncertainty, disputes, and inefficiency if not properly implemented. The aim of our research is to apply techniques from intelligent control theory and decision-making theory to define an Intelligent Aircraft/Airspace System (IAAS) for the year 2025. The IAAS would make effective use of the technical capabilities of all parts of the system to meet the demand for increased capacity with improved performance.

Study on Equity and Efficiency of Health Resources and Services Based on Key Indicators in China

PubMed Central

Zhang, Xinyu; Zhao, Lin; Cui, Zhuang; Wang, Yaogang

2015-01-01

Background This study aims to evaluate the dialectical relationship between equity and efficiency of health resource allocation and health service utilization in China. Methods We analyzed the inequity of health resource allocation and health service utilization based on concentration index (CI) and Gini coefficient. Data envelopment analysis (DEA) was used to evaluate the inefficiency of resource allocation and service utilization. Factor Analysis (FA) was used to determine input/output indicators. Results The CI of Health Institutions, Beds in Health Institutions, Health Professionals and Outpatient Visits were -0.116, -0.012, 0.038, and 0.111, respectively. Gini coefficient for the 31 provinces varied between 0.05 and 0.43; out of these 23 (742%) were observed to be technically efficient constituting the “best practice frontier”. The other 8 (25.8%) provinces were technically inefficient. Conclusions Health professionals and outpatient services are focused on higher income levels, while the Health Institutions and Beds in Health Institutions were concentrated on lower income levels. In China, a few provinces attained a basic balance in both equity and efficiency in terms of current health resource and service utilization, thus serving as a reference standard for other provinces. PMID:26679187

Study on Equity and Efficiency of Health Resources and Services Based on Key Indicators in China.

PubMed

Zhang, Xinyu; Zhao, Lin; Cui, Zhuang; Wang, Yaogang

2015-01-01

This study aims to evaluate the dialectical relationship between equity and efficiency of health resource allocation and health service utilization in China. We analyzed the inequity of health resource allocation and health service utilization based on concentration index (CI) and Gini coefficient. Data envelopment analysis (DEA) was used to evaluate the inefficiency of resource allocation and service utilization. Factor Analysis (FA) was used to determine input/output indicators. The CI of Health Institutions, Beds in Health Institutions, Health Professionals and Outpatient Visits were -0.116, -0.012, 0.038, and 0.111, respectively. Gini coefficient for the 31 provinces varied between 0.05 and 0.43; out of these 23 (742%) were observed to be technically efficient constituting the "best practice frontier". The other 8 (25.8%) provinces were technically inefficient. Health professionals and outpatient services are focused on higher income levels, while the Health Institutions and Beds in Health Institutions were concentrated on lower income levels. In China, a few provinces attained a basic balance in both equity and efficiency in terms of current health resource and service utilization, thus serving as a reference standard for other provinces.

Measuring the efficiency of the Greek rural primary health care using a restricted DEA model; the case of southern and western Greece.

PubMed

Oikonomou, Nikolaos; Tountas, Yannis; Mariolis, Argiris; Souliotis, Kyriakos; Athanasakis, Kostas; Kyriopoulos, John

2016-12-01

This is a study to measure the efficiency of the rural Health Centres (HCs) and their Regional Surgeries (RSs) of the 6th Health Prefecture (HP) of Greece, which covers Southern and Western Greece. Data Envelopment Analysis (DEA) was applied under Constant and Variable Returns to Scale, using a weight-restricted, output-oriented model, to calculate pure technical efficiency (PΤΕ), scale efficiency (SE) and total technical efficiency (TE). The selection of inputs, outputs and their relative weights in the model was based on two consecutive consensus panels of experts on Primary Health Care (PHC). Medical personnel, nursing personnel and technological equipment were chosen as inputs and were attributed appropriate weight restrictions. Acute, chronic and preventive consultations where chosen as outputs; each output was constructed by smaller subcategories of different relative importance. Data were collected through a questionnaire sent to all HCs of the covered area. From the 42 HCs which provided complete data, the study identified 9 as technical efficient, 5 as scale efficient and 2 as total efficient. The mean TE, PTE and SE scores of the HCs of the 6th Health Prefecture were 0.57, 0.67 and 0.87, respectively. The results demonstrate noteworthy variation in efficiency in the productive process of the HCs of Southern and Western Greece. The dominant form of inefficiency was technical inefficiency. The HCs of the 6th HP can theoretically produce 33 % more output on average, using their current production factors. These results indicated potential for considerable efficiency improvement in most rural health care units. Emphasis on prevention and chronic disease management, as well as wider structural and organisational reforms, are discussed from the viewpoint of how to increase efficiency.

Public and Private Hospital Services Reform Using Data Envelopment Analysis to Measure Technical, Scale, Allocative, and Cost Efficiencies

PubMed Central

Sheikhzadeh, Yaghoub; Roudsari, Abdul V.; Vahidi, Reza Gholi; Emrouznejad, Ali; Dastgiri, Saeed

2012-01-01

Background: The aim of this study was to suggest a suitable context to develop efficient hospital systems while maintaining the quality of care at minimum expenditures. Methods: This research aimed to present a model of efficiency for selected public and private hospitals of East Azerbaijani Province of Iran by making use of Data Envelopment Analysis approach in order to recognize and suggest the best practice standards. Results: Among the six inefficient hospitals, 2 (33%) had a technical efficiency score of less than 50% (both private), 2 (33%) between 51 and 74% (one private and one public) and the rest (2, 33%) between 75 and 99% (one private and one public). Conclusion: In general, the public hospitals are relatively more efficient than private ones; it is recommended for inefficient hospitals to make use of the followings: transferring, selling, or renting idle/unused beds; transferring excess doctors and nurses to the efficient hospitals or other health centers; pensioning off, early retirement clinic officers, technicians/technologists, and other technical staff. The saving obtained from the above approaches could be used to improve remuneration for remaining staff and quality of health care services of hospitals, rural and urban health centers, support communities to start or sustain systematic risk and resource pooling and cost sharing mechanisms for protecting beneficiaries against unexpected health care costs, compensate the capital depreciation, increasing investments, and improve diseases prevention services and facilities in the provincial level. PMID:24688915

Public and private hospital services reform using data envelopment analysis to measure technical, scale, allocative, and cost efficiencies.

PubMed

Sheikhzadeh, Yaghoub; Roudsari, Abdul V; Vahidi, Reza Gholi; Emrouznejad, Ali; Dastgiri, Saeed

2012-01-01

The aim of this study was to suggest a suitable context to develop efficient hospital systems while maintaining the quality of care at minimum expenditures. This research aimed to present a model of efficiency for selected public and private hospitals of East Azerbaijani Province of Iran by making use of Data Envelopment Analysis approach in order to recognize and suggest the best practice standards. Among the six inefficient hospitals, 2 (33%) had a technical efficiency score of less than 50% (both private), 2 (33%) between 51 and 74% (one private and one public) and the rest (2, 33%) between 75 and 99% (one private and one public). In general, the public hospitals are relatively more efficient than private ones; it is recommended for inefficient hospitals to make use of the followings: transferring, selling, or renting idle/unused beds; transferring excess doctors and nurses to the efficient hospitals or other health centers; pensioning off, early retirement clinic officers, technicians/technologists, and other technical staff. The saving obtained from the above approaches could be used to improve remuneration for remaining staff and quality of health care services of hospitals, rural and urban health centers, support communities to start or sustain systematic risk and resource pooling and cost sharing mechanisms for protecting beneficiaries against unexpected health care costs, compensate the capital depreciation, increasing investments, and improve diseases prevention services and facilities in the provincial level.

Measuring the efficiency of a healthcare waste management system in Serbia with data envelopment analysis.

PubMed

Ratkovic, Branislava; Andrejic, Milan; Vidovic, Milorad

2012-06-01

In 2007, the Serbian Ministry of Health initiated specific activities towards establishing a workable model based on the existing administrative framework, which corresponds to the needs of healthcare waste management throughout Serbia. The objective of this research was to identify the reforms carried out and their outcomes by estimating the efficiencies of a sample of 35 healthcare facilities engaged in the process of collection and treatment of healthcare waste, using data envelopment analysis. Twenty-one (60%) of the 35 healthcare facilities analysed were found to be technically inefficient, with an average level of inefficiency of 13%. This fact indicates deficiencies in the process of collection and treatment of healthcare waste and the information obtained and presented in this paper could be used for further improvement and development of healthcare waste management in Serbia.

East Europe Report

DTIC Science & Technology

1987-01-07

technically advanced, high quality product, but also to the perceived economic impact of a given innova- tion. This is defined for exported products...chronic woe of all socialist systems is economic inefficiency. This is apparently the one thing about which there was no disagreement at the ...International Round Table on "Socialism and Economics ," which was held from 20 through 24 October in Cavtata. In fact, if not the very existence of , then at

Universalization of Primary Education in Colombia: The New School Programme. Notes, Comments... No. 191 = Colombie: L'enseignement primaire pour tous le programme "Ecole nouvelle."

ERIC Educational Resources Information Center

Colbert, Vicky; Arboleda, Jairo

For the first time, Colombia is in a position to comply with the article of her constitution which guarantees a primary education to all citizens. The country now has the technical, political and financial conditions necessary to universalize primary education, particularly in rural areas where low coverage and inefficiency of the system have…

Technical and Economic Aspects of Low Emission Reduction in Poland

NASA Astrophysics Data System (ADS)

Dzikuć, M.; Łasiński, K.

2017-12-01

The paper presents the problem of excessive air pollution in Poland caused mainly by low emission. The emission arises in result of heating flats by means of old and energetically inefficient heating installations. In Poland and Bulgaria the inhaled air is of the worst quality out of all EU countries. The paper presents economic and technical problems related to low emission occurring during the combustion of solid fuels in local boiler houses. Furthermore, the most significant economic issues, connected with the reduction of low emission are discussed, as well as technological possibilities of efficient reduction of the amount of pollution in the atmosphere. Conclusions are presented at the end of the article.

From Crew Communication to Coordination: A Fundamental Means to an End

NASA Technical Reports Server (NTRS)

Kanki, Barbara G.; Connors, Mary M. (Technical Monitor)

1998-01-01

This viewgraph presentation describes the purposes and contexts of communication, factors which affect the interpretation of communication, and the advantages of effective, systematic communication to and from crews. Communication accomplishes information transfer, team/task management, shared problem solving and decision making, and establishment of the interpersonal climate. These accomplishments support outcomes: Technical task performance; CRM (crew resource management); Procedures and ATC (air traffic control); and Work/team atmosphere. The presentation lists various types of management inefficiency which can result from a lack of each of the four accomplishments. Communication skills are used within the following contexts: physical; social and organizational; task and operational; and speech and linguistic. Crew communication can be evaluated through investigation (case study), research (experimentation), and training.

Market inefficiency identified by both single and multiple currency trends

NASA Astrophysics Data System (ADS)

Tokár, T.; Horváth, D.

2012-11-01

Many studies have shown that there are good reasons to claim very low predictability of currency returns; nevertheless, the deviations from true randomness exist which have potential predictive and prognostic power [J. James, Simple trend-following strategies in currency trading, Quantitative finance 3 (2003) C75-C77]. We analyze the local trends which are of the main focus of the technical analysis. In this article we introduced various statistical quantities examining role of single temporal discretized trend or multitude of grouped trends corresponding to different time delays. Our specific analysis based predominantly on Euro-dollar currency pair data at the one minute frequency suggests the importance of cumulative nonrandom effect of trends on the potential forecasting performance.

Genetic testing when there is a mix of compulsory and voluntary health insurance.

PubMed

Hoel, Michael; Iversen, Tor

2002-03-01

When the insurer has access to information about test status, genetic insurance can handle the negative effects of genetic testing on insurance coverage and income distribution. Hence, efficient testing is promoted. When information about prevention and test status is private, two types of social inefficiencies may occur; genetic testing may not be done when it is socially efficient and genetic testing may be done although it is socially inefficient. The first type of inefficiency is shown to be likely for consumers with compulsory insurance only, while the second type of inefficiency is more likely for those who have supplemented the compulsory insurance with substantial voluntary insurance. This second type of inefficiency is more important the less effective prevention is. It is therefore a puzzle that many countries have imposed strict regulation on the genetic information insurers have access to. A reason may be that genetic insurance is not yet a political issue, and the advantage of shared genetic information is therefore not transparent.

Technical variations in low-input RNA-seq methodologies.

PubMed

Bhargava, Vipul; Head, Steven R; Ordoukhanian, Phillip; Mercola, Mark; Subramaniam, Shankar

2014-01-14

Recent advances in RNA-seq methodologies from limiting amounts of mRNA have facilitated the characterization of rare cell-types in various biological systems. So far, however, technical variations in these methods have not been adequately characterized, vis-à-vis sensitivity, starting with reduced levels of mRNA. Here, we generated sequencing libraries from limiting amounts of mRNA using three amplification-based methods, viz. Smart-seq, DP-seq and CEL-seq, and demonstrated significant technical variations in these libraries. Reduction in mRNA levels led to inefficient amplification of the majority of low to moderately expressed transcripts. Furthermore, noise in primer hybridization and/or enzyme incorporation was magnified during the amplification step resulting in significant distortions in fold changes of the transcripts. Consequently, the majority of the differentially expressed transcripts identified were either high-expressed and/or exhibited high fold changes. High technical variations ultimately masked subtle biological differences mandating the development of improved amplification-based strategies for quantitative transcriptomics from limiting amounts of mRNA.

Features of electric drive sucker rod pumps for oil production

NASA Astrophysics Data System (ADS)

Gizatullin, F. A.; Khakimyanov, M. I.; Khusainov, F. F.

2018-01-01

This article is about modes of operation of electric drives of downhole sucker rod pumps. Downhole oil production processes are very energy intensive. Oil fields contain many oil wells; many of them operate in inefficient modes with significant additional losses. Authors propose technical solutions to improve energy performance of a pump unit drives: counterweight balancing, reducing of electric motor power, replacing induction motors with permanent magnet motors, replacing balancer drives with chain drives, using of variable frequency drives.

Analysis of the Federal Aviation Administration’s Host Computer Acquisition Process and Potential Application in Department of Defense Acquisitions

DTIC Science & Technology

1988-09-01

defense programs lost far more to inefficient procedures than to fraud and dishonesty * (President’s Commission, l986c:15). Based on the Commission...recommendations from current studies, lessons learned from a successful program, and DOD expert opinions to develop an acquisition management strategy that...established for the alternative(s) selected in the preceding phase. 5. In the concept demonstration/validation phase the technical risk and economic

Performance of US teaching hospitals: a panel analysis of cost inefficiency.

PubMed

Rosko, Michael D

2004-02-01

This research summarizes an analysis of the impact of environment pressures on hospital inefficiency during the period 1990-1999. The panel design included 616 hospitals. Of these, 211 were academic medical centers and 415 were hospitals with smaller teaching programs. The primary sources of data were the American Hospital Association's Annual Survey of Hospitals and Medicare Cost Reports. Hospital inefficiency was estimated by a regression technique called stochastic frontier analysis. This technique estimates a "best practice cost frontier" for each hospital that is based on the hospital's outputs and input prices. The cost efficiency of each hospital was defined as the ratio of the stochastic frontier total costs to observed total costs. Average inefficiency declined from 14.35% in 1990 to 11.42% in 1998. It increased to 11.78% in 1999. Decreases in inefficiency were associated with the HMO penetration rate and time. Increases in inefficiency were associated with for-profit ownership status and Medicare share of admissions. The implementation of the provisions of the Balanced Budget Act of 1997 was followed by a small decrease in average hospital inefficiency. Analysis found that the SFA results were moderately sensitive to the specification of the teaching output variable. Thus, although the SFA technique can be useful for detecting differences in inefficiency between groups of hospitals (i.e., those with high versus those with low Medicare shares or for-profit versus not-for-profit hospitals), its relatively low precision indicates it should not be used for exact estimates of the magnitude of differences associated with inefficiency-effects variables.

E-KIT: An Electronic-Knowledge Information Tool for Organizing Site Information and Improving Technical Communication with Stakeholders - 13082

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kautsky, Mark; Findlay, Richard C.; Hodges, Rex A.

2013-07-01

Managing technical references for projects that have long histories is hampered by the large collection of documents, each of which might contain discrete pieces of information relevant to the site conceptual model. A database application has been designed to improve the efficiency of retrieving technical information for a project. Although many databases are currently used for accessing analytical and geo-referenced data, applications designed specifically to manage technical reference material for projects are scarce. Retrieving site data from the array of available references becomes an increasingly inefficient use of labor. The electronic-Knowledge Information Tool (e-KIT) is designed as a project-level resourcemore » to access and communicate technical information. The e-KIT is a living tool that grows as new information becomes available, and its value to the project increases as the volume of site information increases. Having all references assembled in one location with complete reference citations and links to elements of the site conceptual model offers a way to enhance communication with outside groups. The published and unpublished references are incorporated into the e-KIT, while the compendium of references serves as a complete bibliography for the project. (authors)« less

Development of a rapid response plan for intraoperative emergencies: the Circulate, Scrub, and Technical Assistance Team.

PubMed

Earle, David; Betti, Diane; Scala, Emilia

2017-01-01

Unplanned intraoperative events are inevitable and cause stress and inefficiency among staff. We believe that developing a technical rapid response team with explicitly defined, narrow roles would reduce the amount of chaos during such emergencies. This article provides a detailed description of the development and implementation of such a program. In-situ simulation of an intraoperative emergency was used for a formal assessment of the current practice. Debriefing sessions identified areas of improvement and solicited solutions. A multidisciplinary working group then developed and implemented the technical rapid response team based on the needs assessment. The program was designed to create a Circulating, Scrubbing, and Technical Assistance Team that helps with equipment, supplies, anesthesia, and communication. We anticipate the program will foster a culture of safety, and promote positive relationships and attitudes of the entire multidisciplinary team. In the future, research regarding patient outcomes and staff satisfaction and safety attitudes may help provide objective evidence of the benefits of the program. Copyright © 2016 Elsevier Inc. All rights reserved.

Exacerbating the Tragedy of the Commons: Private Inefficient Outcomes and Peer Effect in Experimental Games with Fishing Communities

PubMed Central

2016-01-01

Economic Experimental Games have shown that individuals make decisions that deviate down from the suboptimal Nash equilibrium. However, few studies have analyzed the case when deviation is above the Nash equilibrium. Extracting from above the Nash equilibrium is inefficient not only socially but also privately and it would exacerbate the tragedy of the commons. That would be the case of a race to the fish when stocks are becoming depleted or driver behavior on a highly congested road. The objective of this study is to analyze private inefficient extraction behavior in experimental games and to associate the type of player and the type of player group with such inefficient outcomes. To do this, we carried out economic experimental games with local coastal fishermen in Colombia, using a setting where the scarcity of the resource allows for an interior Nash equilibrium and inefficient over-extraction is possible. The state of the resource, the type of player and the composition of the group explain, in part, this inefficient behavior. PMID:26863228

Daemen Alternative Energy/Geothermal Technologies Demonstration Program Erie County

DOE Office of Scientific and Technical Information (OSTI.GOV)

Beiswanger, Jr, Robert C

2010-05-20

The purpose of the Daemen Alternative Energy/Geothermal Technologies Demonstration Project is to demonstrate the use of geothermal technology as model for energy and environmental efficiency in heating and cooling older, highly inefficient buildings. The former Marian Library building at Daemen College is a 19,000 square foot building located in the center of campus. Through this project, the building was equipped with geothermal technology and results were disseminated. Gold LEED certification for the building was awarded. 1) How the research adds to the understanding of the area investigated. This project is primarily a demonstration project. Information about the installation is availablemore » to other companies, organizations, and higher education institutions that may be interested in using geothermal energy for heating and cooling older buildings. 2) The technical effectiveness and economic feasibility of the methods or techniques investigated or demonstrated. According to the modeling and estimates through Stantec, the energy-efficiency cost savings is estimated at 20%, or $24,000 per year. Over 20 years this represents $480,000 in unrestricted revenue available for College operations. See attached technical assistance report. 3) How the project is otherwise of benefit to the public. The Daemen College Geothermal Technologies Ground Source Heat Pumps project sets a standard for retrofitting older, highly inefficient, energy wasting and environmentally irresponsible buildings quite typical of many of the buildings on the campuses of regional colleges and universities. As a model, the project serves as an energy-efficient system with significant environmental advantages. Information about the energy-efficiency measures is available to other colleges and universities, organizations and companies, students, and other interested parties. The installation and renovation provided employment for 120 individuals during the award period. Through the new Center, Daemen will continue to host a range of events on campus for the general public. The College does not charge fees for speakers or most other events. This has been a long-standing tradition of the College.« less

Daemen Alternative Energy/Geothermal Technologies Demonstration Program, Erie County

DOE Office of Scientific and Technical Information (OSTI.GOV)

Beiswanger, Robert C.

The purpose of the Daemen Alternative Energy/Geothermal Technologies Demonstration Project is to demonstrate the use of geothermal technology as model for energy and environmental efficiency in heating and cooling older, highly inefficient buildings. The former Marian Library building at Daemen College is a 19,000 square foot building located in the center of campus. Through this project, the building was equipped with geothermal technology and results were disseminated. Gold LEED certification for the building was awarded. 1) How the research adds to the understanding of the area investigated. This project is primarily a demonstration project. Information about the installation is availablemore » to other companies, organizations, and higher education institutions that may be interested in using geothermal energy for heating and cooling older buildings. 2) The technical effectiveness and economic feasibility of the methods or techniques investigated or demonstrated. According to the modeling and estimates through Stantec, the energy-efficiency cost savings is estimated at 20%, or $24,000 per year. Over 20 years this represents $480,000 in unrestricted revenue available for College operations. See attached technical assistance report. 3) How the project is otherwise of benefit to the public. The Daemen College Geothermal Technologies Ground Source Heat Pumps project sets a standard for retrofitting older, highly inefficient, energy wasting and environmentally irresponsible buildings that are quite typical of many of the buildings on the campuses of regional colleges and universities. As a model, the project serves as an energy-efficient system with significant environmental advantages. Information about the energy-efficiency measures is available to other colleges and universities, organizations and companies, students, and other interested parties. The installation and renovation provided employment for 120 individuals during the award period. Through the new Center, Daemen will continue to host a range of events on campus for the general public. The College does not charge fees for speakers or most other events. This has been a long-standing tradition of the College.« less

Efficiency of U.S. Dialysis Centers: An Updated Examination of Facility Characteristics That Influence Production of Dialysis Treatments

PubMed Central

Shreay, Sanatan; Ma, Martin; McCluskey, Jill; Mittelhammer, Ron C; Gitlin, Matthew; Stephens, J Mark

2014-01-01

Objective To explore the relative efficiency of dialysis facilities in the United States and identify factors that are associated with efficiency in the production of dialysis treatments. Data Sources/Study Setting Medicare cost report data from 4,343 free-standing dialysis facilities in the United States that offered in-center hemodialysis in 2010. Study Design A cross-sectional, facility-level retrospective database analysis, utilizing data envelopment analysis (DEA) to estimate facility efficiency. Data Collection/Extraction Methods Treatment data and cost and labor inputs of dialysis treatments were obtained from 2010 Medicare Renal Cost Reports. Demographic data were obtained from the 2010 U.S. Census. Principal Findings Only 26.6 percent of facilities were technically efficient. Neither the intensity of market competition nor the profit status of the facility had a significant effect on efficiency. Facilities that were members of large chains were less likely to be efficient. Cost and labor savings due to changes in drug protocols had little effect on overall dialysis center efficiency. Conclusions The majority of free-standing dialysis facilities in the United States were functioning in a technically inefficient manner. As payment systems increasingly employ capitation and bundling provisions, these institutions will need to evaluate their efficiency to remain competitive. PMID:24237043

Measuring technical efficiency of output quality in intensive care units.

PubMed

Junoy, J P

1997-01-01

Presents some examples of the implications derived from imposing the objective of maximizing social welfare, subject to limited resources, on ethical care patients management in respect of quality performance of health services. Conventional knowledge of health economics points out that critically ill patients are responsible for increased use of technological resources and that they receive a high proportion of health care resources. Attempts to answer, from the point of view of microeconomics, the question: how do we measure comparative efficiency in the management of intensive care units? Analyses this question through data from an international empirical study using micro-economic measures of productive efficiency in public services (data envelopment analysis). Results show a 28.8 per cent level of technical inefficiency processing data from 25 intensive care units in the USA.

Technical and scale efficiency in the delivery of child health services in Zambia: results from data envelopment analysis

PubMed Central

Achoki, Tom; Hovels, Anke; Masiye, Felix; Lesego, Abaleng; Leufkens, Hubert; Kinfu, Yohannes

2017-01-01

Objective Despite tremendous efforts to scale up key maternal and child health interventions in Zambia, progress has not been uniform across the country. This raises fundamental health system performance questions that require further investigation. Our study investigates technical and scale efficiency (SE) in the delivery of maternal and child health services in the country. Setting The study focused on all 72 health districts of Zambia. Methods We compiled a district-level database comprising health outcomes (measured by the probability of survival to 5 years of age), health outputs (measured by coverage of key health interventions) and a set of health system inputs, namely, financial resources and human resources for health, for the year 2010. We used data envelopment analysis to assess the performance of subnational units across Zambia with respect to technical and SE, controlling for environmental factors that are beyond the control of health system decision makers. Results Nationally, average technical efficiency with respect to improving child survival was 61.5% (95% CI 58.2% to 64.8%), which suggests that there is a huge inefficiency in resource use in the country and the potential to expand services without injecting additional resources into the system. Districts that were more urbanised and had a higher proportion of educated women were more technically efficient. Improved cooking methods and donor funding had no significant effect on efficiency. Conclusions With the pressing need to accelerate progress in population health, decision makers must seek efficient ways to deliver services to achieve universal health coverage. Understanding the factors that drive performance and seeking ways to enhance efficiency offer a practical pathway through which low-income countries could improve population health without necessarily seeking additional resources. PMID:28057650

The Determinants of the Technical Efficiency of Acute Inpatient Care in Canada.

PubMed

Wang, Li; Grignon, Michel; Perry, Sheril; Chen, Xi-Kuan; Ytsma, Alison; Allin, Sara; Gapanenko, Katerina

2018-04-17

To evaluate the technical efficiency of acute inpatient care at the pan-Canadian level and to explore the factors associated with inefficiency-why hospitals are not on their production frontier. Canadian Management Information System (MIS) database (CMDB) and Discharge Abstract Database (DAD) for the fiscal year of 2012-2013. We use a nonparametric approach (data envelopment analysis) applied to three peer groups (teaching, large, and medium hospitals, focusing on their acute inpatient care only). The double bootstrap procedure (Simar and Wilson 2007) is adopted in the regression. Information on inpatient episodes of care (number and quality of outcomes) was extracted from the DAD. The cost of the inpatient care was extracted from the CMDB. On average, acute hospitals in Canada are operating at about 75 percent efficiency, and this could thus potentially increase their level of outcomes (quantity and quality) by addressing inefficiencies. In some cases, such as for teaching hospitals, the factors significantly correlated with efficiency scores were not related to management but to the social composition of the caseload. In contrast, for large and medium nonteaching hospitals, efficiency related more to the ability to discharge patients to postacute care facilities. The efficiency of medium hospitals is also positively related to treating more clinically noncomplex patients. The main drivers of efficiency of acute inpatient care vary by hospital peer groups. Thus, the results provide different policy and managerial implications for teaching, large, and medium hospitals to achieve efficiency gains. © Health Research and Educational Trust.

Measuring the efficiency of Palestinian public hospitals during 2010-2015: an application of a two-stage DEA method.

PubMed

Sultan, Wasim I M; Crispim, José

2018-05-29

While health needs and expenditure in the Occupied Palestinian Territories (OPT) are growing, the international donations are declining and the economic situation is worsening. The purpose of this paper is twofold, to evaluate the productive efficiency of public hospitals in West Bank and to study contextual factors contributing to efficiency differences. This study examined technical efficiency among 11 public hospitals in West Bank from 2010 through 2015 targeting a total of 66 observations. Nationally representative data were extracted from the official annual health reports. We applied input-oriented Data Envelopment Analysis (DEA) models to estimate efficiency scores. To elaborate further on performance, we used Tobit regression to identify contextual factors whose impact on inefficient performance is statistically significant. Despite the increase in efficiency mean scores by 4% from 2010 to 2015, findings show potential savings of 14.5% of resource consumption without reducing the volume of the provided services. The significant Tobit model showed four predictors explaining the inefficient performance of a hospital (p <  0.01) are: bed occupancy rate (BOR); the outpatient-inpatient ratio (OPIPR); hospital's size (SIZE); and the availability of primary healthcare centers within the hospital's catchment area (PRC). There is a strong effect of OPIPR on efficiency differences between hospitals: A one unit increase in OPIPR will lead a decrease of 19.7% in the predicted inefficiency level holding all other factors constant. To date, no previous studies have examined the efficiency of public hospitals in the OPT. Our work identified their efficiency levels for potential improvements and the determinants of efficient performance. Based on the measurement of efficiency, the generated information may guide hospitals' managers, policymakers, and international donors improving the performance of the main national healthcare provider. The scope of this study is limited to public hospitals in West Bank. For a better understanding of the Palestinian market, further research on private hospitals and hospitals in Gaza Strip will be useful.

Lactation and reproduction*

PubMed Central

Thomson, A. M.; Hytten, F. E.; Black, A. E.

1975-01-01

The authors review the literature on the effect of lactation on fertility in the absence of contraception and on the effects of contraceptive measures on lactation. They examine data from several countries on the intervals between births and on the return of menstruation and ovulation after childbirth, comparing lactating with nonlactating women. They conclude that lactation is an inefficient contraceptive for the individual, but that in populations sustained lactation is associated with reduced fertility. Possible physiological mechanisms causing lactation amenorrhoea are discussed. Though much of the literature on the effect of contraceptives on lactation is inadequate, there is general agreement that the estrogen component of hormonal preparations has an adverse effect on lactation, but that progestins alone do not. Many questions remain. Is this effect seen in established lactation, or only in the puerperal period? Is it a direct pharmacological effect, or are pill-users the mothers least motivated to maintain breast-feeding? Does a close relationship exist between hormones given and lactation performance? The authors comment on some of the technical deficiencies of previous studies in this field and discuss practical possibilities of, and limitations to, obtaining adequate scientific information in the future. PMID:1084804

A telemedicine model for integrating point-of-care testing into a distributed health-care environment.

PubMed

Villalar, J L; Arredondo, M T; Meneu, T; Traver, V; Cabrera, M F; Guillen, S; Del Pozo, F

2002-01-01

Centralized testing demands costly laboratories, which are inefficient and may provide poor services. Recent advances make it feasible to move clinical testing nearer to patients and the requesting physicians, thus reducing the time to treatment. Internet technologies can be used to create a virtual laboratory information system in a distributed health-care environment. This allows clinical testing to be transferred to a cooperative scheme of several point-of-care testing (POCT) nodes. Two pilot virtual laboratories were established, one in Italy (AUSL Modena) and one in Greece (Athens Medical Centre). They were constructed on a three-layer model to allow both technical and clinical verification. Different POCT devices were connected. The pilot sites produced good preliminary results in relation to user acceptance, efficiency, convenience and costs. Decentralized laboratories can be expected to become cost-effective.

Financing Education: Overcoming Inefficiency and Inequity.

ERIC Educational Resources Information Center

McMahon, Walter W., Ed.; Geske, Terry G., Ed.

Fiscal inefficiency in education is addressed in this book and ideas for achieving increased efficiency while more effectively using resources to maintain reasonable equality of opportunity in higher education are examined. Fourteen articles and authors that consider social efficiency, equity, and policy implications are as follows: "Efficiency…

Evaluation of performance and impacts of maternal and child health hospital services using Data Envelopment Analysis in Guangxi Zhuang Autonomous Region, China: a comparison study among poverty and non-poverty county level hospitals.

PubMed

Wang, Xuan; Luo, Hongye; Qin, Xianjin; Feng, Jun; Gao, Hongda; Feng, Qiming

2016-08-23

As the core of the county-level Maternal and Child Health Hospitals (MCHH) in rural areas of China, the service efficiency affects the fairness and availability of healthcare services. This study aims to identify the determinants of hospital efficiency and explore how to improve the performance of MCHH in terms of productivity and efficiency. Data was collected from a sample of 32 county-level MCHHs of Guangxi in 2014. Firstly, we specified and measured the indicators of the inputs and outputs which represent hospital resources expended and its profiles respectively. Then we estimated the efficiency scores using Data Envelopment Analysis (DEA) for each hospital. Efficiency scores were decomposed into technical, scale and congestion components, and the potential output increases and/or input reductions were also estimated in this model, which would make relatively inefficient hospitals more efficient. In the second stage, the estimated efficiency scores are regressed against hospital external and internal environment factors using a Tobit model. We used DEAP (V2.1) and R for data analysis. The average scores of technical efficiency, net technical efficiency (managerial efficiency) and scale efficiency of the hospitals were 0.875, 0.922 and 0.945, respectively. Half of the hospitals were efficient, and 9.4 % and 40.6 % were weakly efficient and inefficient, respectively. Among the low-productiveness hospitals, 61.1 % came from poor counties (Poor counties in this article are in the list of key poverty-stricken counties at the national level, published by The State Council Leading Group Office of Poverty Alleviation and Development, 2012). The total input indicated that redundant medical resources in poverty areas were significantly higher than those in non-poverty areas. The Tobit regression model showed that the technical efficiency was proportional to the total annual incomes, the number of discharge patients, and the number of outpatient and emergency visits, while it was inversely proportional to total expenditure and the actual number of open beds. Technical efficiency was not associated with number of health care workers. The overall operational efficiency of the county-level MCHHs in Guangxi was low and needs to be improved. Regional economic differences affect the performances of hospitals. Health administrations should adjust and optimize the resource investments for the different areas. For the hospitals in poverty areas, policy-makers should not only consider the hardware facilities investment, but also the introduction of advanced techniques and high-level medical personnel to improve their technical efficiency.

Artificial neural network models: A decision support tool for enhancing seedling selection in sugarcane

USDA-ARS?s Scientific Manuscript database

Currently, sugarcane selection begins at the seedling stage with visual selection for cane yield and other yield-related traits. Although subjective and inefficient, visual selection remains the primary method for selection. Visual selection is inefficient because of the confounding effect of genoty...

Measuring the performance of neonatal care units in Scotland.

PubMed

Field, Kamal; Emrouznejad, Ali

2003-08-01

Policy makers continue to debate whether or not to increase the share of health care expenditures in United Kingdom. On the other hand, the pressure of operating within tight budgets and the advances in technology are forcing more locally based hospitals to close. One that could be used by policy makers as a benchmark is the measure of relative performance of hospitals. Many researchers have examined the source of inefficiency in health sectors (see, for example, Harris et al., Oper. Res. Soc. 57:801-811, 2000, Ozcan et al., Med. Case 30:781-784, 1992; Ozcan et aL., J. Med. Syst. 20(3)141-150, 1996; and Grosskopf and Valdmanis, J. Health. Econ. 6:89-107, 1987 but there is no evidence of measuring performance of neonatal care units of Scottish hospitals in the DEA literature. The purpose of this paper is to measure both technical and scale efficiency using data envelopment analysis in a selection of 22 neonatal care units in Scotland. The analysis suggests that major inefficiency likely exists in health care production in United Kingdom. There is potential for improving productivity by 20%.

What does free cash flow tell us about hospital efficiency? A stochastic frontier analysis of cost inefficiency in California hospitals.

PubMed

Pratt, William R

2010-01-01

Hospitals are facing substantial financial and economic pressure as a result of health plan payment restructuring, unfunded mandates, and other factors. This article analyzes the relationship between free cash flow (FCF) and hospital efficiency given these financial challenges. Data from 270 California hospitals were used to estimate a stochastic frontier model of hospital cost efficiency that explicitly takes into account outpatient heterogeneity. The findings indicate that hospital FCF is significantly linked to firm efficiency/inefficiency. The results indicate that higher positive cash flows are related to lower cost inefficiency, but higher negative cash flows are related to higher cost inefficiency. Thus, cash flows not only impact the ability of hospitals to meet current liabilities, they are also related to the ability of the hospitals to use resources effectively.

The relationship between hospital specialization and hospital efficiency: do different measures of specialization lead to different results?

PubMed

Lindlbauer, Ivonne; Schreyögg, Jonas

2014-12-01

This study investigated the relationship between hospital specialization and technical efficiency using different measures of specialization, including two novel approaches based on patient volumes rather than patient proportions. It was motivated by the observation that most studies to date have quantified hospital specialization using information about hospital patients grouped into different categories based on their diagnosis, and in doing so have used proportions-thus indirectly assuming that these categories are dependent on one other. In order to account for the diversification of organizations and the idea that hospitals can be specialized in terms of professional expertise or technical equipment within a given diagnosis category, we developed our two specialization measures based on patient volume in each category. Using a one-step stochastic frontier approach on randomly selected data from the annual reports of 1,239 acute care German hospitals for the years 2000 through 2010, we estimated the relationship of inefficiency to exogenous variables, such as specialization. The results show that specialization as quantified by our novel measures has effects on efficiency that are the opposite of those obtained using earlier measures of specialization. These results underscore the importance of always providing an exact definition of specialization when studying its effects. Additionally, a Monte Carlo simulation based on three scenarios is provided to facilitate the choice of a specialization measure for further analysis.

Bachelor's Degree Productivity X-Inefficiency: The Role of State Higher Education Policy

ERIC Educational Resources Information Center

Titus, Marvin A.

2010-01-01

Using stochastic frontier analysis and dynamic fixed-effects panel modeling, this study examines how changes in the x-inefficiency of bachelor's degree production are influenced by changes in state higher education policy. The findings from this research show that increases in need-based state financial aid help to mitigate the convergence among…

Knowledge discovery from data and Monte-Carlo DEA to evaluate technical efficiency of mental health care in small health areas

PubMed Central

García-Alonso, Carlos; Pérez-Naranjo, Leonor

2009-01-01

Introduction Knowledge management, based on information transfer between experts and analysts, is crucial for the validity and usability of data envelopment analysis (DEA). Aim To design and develop a methodology: i) to assess technical efficiency of small health areas (SHA) in an uncertainty environment, and ii) to transfer information between experts and operational models, in both directions, for improving expert’s knowledge. Method A procedure derived from knowledge discovery from data (KDD) is used to select, interpret and weigh DEA inputs and outputs. Based on KDD results, an expert-driven Monte-Carlo DEA model has been designed to assess the technical efficiency of SHA in Andalusia. Results In terms of probability, SHA 29 is the most efficient being, on the contrary, SHA 22 very inefficient. 73% of analysed SHA have a probability of being efficient (Pe) >0.9 and 18% <0.5. Conclusions Expert knowledge is necessary to design and validate any operational model. KDD techniques make the transfer of information from experts to any operational model easy and results obtained from the latter improve expert’s knowledge.

Technical and scale efficiency in the delivery of child health services in Zambia: results from data envelopment analysis.

PubMed

Achoki, Tom; Hovels, Anke; Masiye, Felix; Lesego, Abaleng; Leufkens, Hubert; Kinfu, Yohannes

2017-01-05

Despite tremendous efforts to scale up key maternal and child health interventions in Zambia, progress has not been uniform across the country. This raises fundamental health system performance questions that require further investigation. Our study investigates technical and scale efficiency (SE) in the delivery of maternal and child health services in the country. The study focused on all 72 health districts of Zambia. We compiled a district-level database comprising health outcomes (measured by the probability of survival to 5 years of age), health outputs (measured by coverage of key health interventions) and a set of health system inputs, namely, financial resources and human resources for health, for the year 2010. We used data envelopment analysis to assess the performance of subnational units across Zambia with respect to technical and SE, controlling for environmental factors that are beyond the control of health system decision makers. Nationally, average technical efficiency with respect to improving child survival was 61.5% (95% CI 58.2% to 64.8%), which suggests that there is a huge inefficiency in resource use in the country and the potential to expand services without injecting additional resources into the system. Districts that were more urbanised and had a higher proportion of educated women were more technically efficient. Improved cooking methods and donor funding had no significant effect on efficiency. With the pressing need to accelerate progress in population health, decision makers must seek efficient ways to deliver services to achieve universal health coverage. Understanding the factors that drive performance and seeking ways to enhance efficiency offer a practical pathway through which low-income countries could improve population health without necessarily seeking additional resources. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Measuring efficiency of cotton cultivation in Pakistan: a restricted production frontier study.

PubMed

Watto, Muhammad Arif; Mugera, Amin

2014-11-01

Massive groundwater pumping for irrigation has started lowering water tables rapidly in different regions of Pakistan. Declining water tables have thus prompted research efforts to improve agricultural productivity and efficiency to make efficient use of scarce water resources. This study employs a restricted stochastic production frontier to estimate the level of, and factors affecting, technical efficiency of groundwater-irrigated cotton farms in the Punjab province of Pakistan. The mean technical efficiency estimates indicate substantial technical inefficiencies among cotton growers. On average, tube-well owners and water buyers can potentially increase cotton production by 19% and 28%, respectively, without increasing the existing input level. The most influential factors affecting technical efficiency positively are the use of improved quality seed, consultation with extension field staff and farmers' perceptions concerning the availability of groundwater resources for irrigation in the future. This study proposes that adopting improved seed for new cotton varieties and providing better extension services regarding cotton production technology would help to achieve higher efficiency in cotton farming. Within the context of falling water tables, educating farmers about the actual crop water requirements and guiding them about groundwater resource availability may also help to achieve higher efficiencies. © 2014 Society of Chemical Industry. © 2014 Society of Chemical Industry.

Impact of transaction costs on healthcare outcomes.

PubMed

Stiles, Renée A; So, Stephanie A

2003-06-01

This article reviews transaction cost economics to frame a discussion of how inefficiencies in healthcare delivery processes affect clinical outcomes and differentiate between inefficiencies that are tractable from those that are transitional or intractable. Recognizing and quantifying these effects improves the ability of organizations to calculate returns on investment in quality improvement, research and development and related value enhancing, but it is subject to high-risk undertakings.

[A pilot study in a community pharmacy to determine the efficiency and the effectiveness of statin prescriptions].

PubMed

Ruiz Maldonado, Jose Miguel; Lumbreras, Blanca; Muñoz Jimenez, Hortensia; Navarrete Carranza, Jose Manuel; Anza Aguirrezabala, Ignacio; Pastor-Valero, Maria

2015-05-01

The efficacy of statins to reduce LDL-cholesterol serum levels is high, but effectiveness is limited and costs are elevated. The efficiency and effectiveness of prescriptions were analyzed in a pilot study in a community pharmacy. A cross-sectional study. Community pharmacy. Prescriptions from two Murcian Health Service Centers in Lorca, Murcia (Spain). A total of 141 patients and 32 general practitioners were included. The efficiency was analyzed in 141 and effectiveness in 110 patients. Socio-demographic characteristics and clinical history of patients and information about statin type and dosage were collected. Each patient was analyzed to determine the effectiveness of treatment according to cardiovascular risk and previous LDL-cholesterol level, and efficiency comparing the statin prescribed against other statins with equal pharmacological power. The most prescribed statin was atorvastatin (57.4%). Almost two-thirds (63.9%) of prescriptions were inefficient, and 17.3% were ineffective. In a bivariate analysis, patients with previous cardiovascular events (8/38; 21% vs 41/103; 39.8%. P=.040) and smokers (42/114; 36.8% vs 4/23; 17.4%, P=.047) were more likely to receive an inefficient prescription than patients with no cardiovascular events and non-smokers. In a multivariate analysis, smokers were more likely to receive an inefficient prescription than non-smokers (OR ajusted 3.76; 95% CI;1.03-0.77, P=.012). Most of the participants reached therapeutic objectives for LDL-Cholesterol levels, but more than half of the prescriptions were considered inefficient. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Energy Efficiency in Small Server Rooms: Field Surveys and Findings

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cheung, Iris; Greenberg, Steve; Mahdavi, Roozbeh

Fifty-seven percent of US servers are housed in server closets, server rooms, and localized data centers, in what are commonly referred to as small server rooms, which comprise 99percent of all server spaces in the US. While many mid-tier and enterprise-class data centers are owned by large corporations that consider energy efficiency a goal to minimize business operating costs, small server rooms typically are not similarly motivated. They are characterized by decentralized ownership and management and come in many configurations, which creates a unique set of efficiency challenges. To develop energy efficiency strategies for these spaces, we surveyed 30 smallmore » server rooms across eight institutions, and selected four of them for detailed assessments. The four rooms had Power Usage Effectiveness (PUE) values ranging from 1.5 to 2.1. Energy saving opportunities ranged from no- to low-cost measures such as raising cooling set points and better airflow management, to more involved but cost-effective measures including server consolidation and virtualization, and dedicated cooling with economizers. We found that inefficiencies mainly resulted from organizational rather than technical issues. Because of the inherent space and resource limitations, the most effective measure is to operate servers through energy-efficient cloud-based services or well-managed larger data centers, rather than server rooms. Backup power requirement, and IT and cooling efficiency should be evaluated to minimize energy waste in the server space. Utility programs are instrumental in raising awareness and spreading technical knowledge on server operation, and the implementation of energy efficiency measures in small server rooms.« less

The fiscal cost of weak governance: Evidence from teacher absence in India.

PubMed

Muralidharan, Karthik; Das, Jishnu; Holla, Alaka; Mohpal, Aakash

2017-01-01

The relative return to strategies that augment inputs versus those that reduce inefficiencies remains a key open question for education policy in low-income countries. Using a new nationally-representative panel dataset of schools across 1297 villages in India, we show that the large public investments in education over the past decade have led to substantial improvements in input-based measures of school quality, but only a modest reduction in inefficiency as measured by teacher absence. In our data, 23.6% of teachers were absent during unannounced school visits, and we estimate that the salary cost of unauthorized teacher absence is $1.5 billion/year. We find two robust correlations in the nationally-representative panel data that corroborate findings from smaller-scale experiments. First, reductions in student-teacher ratios are correlated with increased teacher absence. Second, increases in the frequency of school monitoring are strongly correlated with lower teacher absence. Using these results, we show that reducing inefficiencies by increasing the frequency of monitoring could be over ten times more cost effective at increasing the effective student-teacher ratio than hiring more teachers. Thus, policies that decrease the inefficiency of public education spending are likely to yield substantially higher marginal returns than those that augment inputs.

Technical efficiency and productivity of Chinese county hospitals: an exploratory study in Henan province, China.

PubMed

Cheng, Zhaohui; Tao, Hongbing; Cai, Miao; Lin, Haifeng; Lin, Xiaojun; Shu, Qin; Zhang, Ru-Ning

2015-09-09

Chinese county hospitals have been excessively enlarging their scale during the healthcare reform since 2009. The purpose of this paper is to examine the technical efficiency and productivity of county hospitals during the reform process, and to determine whether, and how, efficiency is affected by various factors. 114 sample county hospitals were selected from Henan province, China, from 2010 to 2012. Data envelopment analysis was employed to estimate the technical and scale efficiency of sample hospitals. The Malmquist index was used to calculate productivity changes over time. Tobit regression was used to regress against 4 environmental factors and 5 institutional factors that affected the technical efficiency. (1) 112 (98.2%), 112 (98.2%) and 104 (91.2%) of the 114 sample hospitals ran inefficiently in 2010, 2011 and 2012, with average technical efficiency of 0.697, 0.748 and 0.790, respectively. (2) On average, during 2010-2012, productivity of sample county hospitals increased by 7.8%, which was produced by the progress in technical efficiency changes and technological changes of 0.9% and 6.8%, respectively. (3) Tobit regression analysis indicated that government subsidy, hospital size with above 618 beds and average length of stay assumed a negative sign with technical efficiency; bed occupancy rate, ratio of beds to nurses and ratio of nurses to physicians assumed a positive sign with technical efficiency. There was considerable space for technical efficiency improvement in Henan county hospitals. During 2010-2012, sample hospitals experienced productivity progress; however, the adverse change in pure technical efficiency should be emphasised. Moreover, according to the Tobit results, policy interventions that strictly supervise hospital bed scale, shorten the average length of stay and coordinate the proportion among physicians, nurses and beds, would benefit hospital efficiency. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Technical efficiency and productivity of Chinese county hospitals: an exploratory study in Henan province, China

PubMed Central

Cheng, Zhaohui; Tao, Hongbing; Cai, Miao; Lin, Haifeng; Lin, Xiaojun; Shu, Qin; Zhang, Ru-ning

2015-01-01

Objectives Chinese county hospitals have been excessively enlarging their scale during the healthcare reform since 2009. The purpose of this paper is to examine the technical efficiency and productivity of county hospitals during the reform process, and to determine whether, and how, efficiency is affected by various factors. Setting and participants 114 sample county hospitals were selected from Henan province, China, from 2010 to 2012. Outcome measures Data envelopment analysis was employed to estimate the technical and scale efficiency of sample hospitals. The Malmquist index was used to calculate productivity changes over time. Tobit regression was used to regress against 4 environmental factors and 5 institutional factors that affected the technical efficiency. Results (1) 112 (98.2%), 112 (98.2%) and 104 (91.2%) of the 114 sample hospitals ran inefficiently in 2010, 2011 and 2012, with average technical efficiency of 0.697, 0.748 and 0.790, respectively. (2) On average, during 2010–2012, productivity of sample county hospitals increased by 7.8%, which was produced by the progress in technical efficiency changes and technological changes of 0.9% and 6.8%, respectively. (3) Tobit regression analysis indicated that government subsidy, hospital size with above 618 beds and average length of stay assumed a negative sign with technical efficiency; bed occupancy rate, ratio of beds to nurses and ratio of nurses to physicians assumed a positive sign with technical efficiency. Conclusions There was considerable space for technical efficiency improvement in Henan county hospitals. During 2010–2012, sample hospitals experienced productivity progress; however, the adverse change in pure technical efficiency should be emphasised. Moreover, according to the Tobit results, policy interventions that strictly supervise hospital bed scale, shorten the average length of stay and coordinate the proportion among physicians, nurses and beds, would benefit hospital efficiency. PMID:26353864

DOE Office of Scientific and Technical Information (OSTI.GOV)

Price, L.K.; Phylipsen, G.J.M.; Worrell, E.

Iron and steel production consumes enormous quantities of energy, especially in developing countries where outdated, inefficient technologies are still used to produce iron and steel. Carbon dioxide emissions from steel production, which range between 5 and 15% of total country emissions in key developing countries (Brazil, China, India, Mexico, and South Africa), will continue to grow as these countries develop and as demand for steel products such as materials, automobiles, and appliances increases. In this report, we describe the key steel processes, discuss typical energy-intensity values for these processes, review historical trends in iron and steel production by process inmore » five key developing countries, describe the steel industry in each of the five key developing countries, present international comparisons of energy use and carbon dioxide emissions among these countries, and provide our assessment of the technical potential to reduce these emissions based on best-practice benchmarking. Using a best practice benchmark, we find that significant savings, in the range of 33% to 49% of total primary energy used to produce steel, are technically possible in these countries. Similarly, we find that the technical potential for reducing intensities of carbon dioxide emissions ranges between 26% and 49% of total carbon dioxide emissions from steel production in these countries.« less

Inefficiency, heterogeneity and spillover effects in maternal care in India: a spatial stochastic frontier analysis.

PubMed

Kinfu, Yohannes; Sawhney, Monika

2015-03-25

Institutional delivery is one of the key and proven strategies to reduce maternal deaths. Since the 1990s, the government of India has made substantial investment on maternal care to reduce the huge burden of maternal deaths in the country. However, despite the effort access to institutional delivery in India remains below the global average. In addition, even in places where health investments have been comparable, inter- and intra-state difference in access to maternal care services remain wide and substantial. This raises a fundamental question on whether the sub-national units themselves differ in terms of the efficiency with which they use available resources, and if so, why? Data obtained from round 3 of the country's District Level Health and Facility Survey was analyzed to measure the level and determinants of inefficiency of institutional delivery in the country. Analysis was conducted using spatial stochastic frontier models that correct for heterogeneity and spatial interactions between sub-national units. Inefficiency differences in maternal care services between and within states are substantial. The top one third of districts in the country has a mean efficiency score of 90 per cent or more, while the bottom 10 per cent of districts exhibit mean inefficiency score of as high as over 75 per cent or more. Overall mean inefficiency is about 30 per cent. The result also reveals the existence of both heterogeneity and spatial correlation in institutional delivery in the country. Given the high level of inefficiency in the system, further progress in improving coverage of institutional delivery in the country should focus both on improving the efficiency of resource utilization--especially where inefficiency levels are extremely high--and on bringing new resources in to the system. The additional investment should specifically focus on those parts of the country where coverage rates are still low but efficiency levels are already at a high level. In addition, given that inefficiency was also associated inversely with literacy and urbanization and positively related with proportion of households belonging to poor households, investment in these areas can also improve coverage of institutional delivery in the country.

Use of patient flow analysis to improve patient visit efficiency by decreasing wait time in a primary care-based disease management programs for anticoagulation and chronic pain: a quality improvement study.

PubMed

Potisek, Nicholas M; Malone, Robb M; Shilliday, Betsy Bryant; Ives, Timothy J; Chelminski, Paul R; DeWalt, Darren A; Pignone, Michael P

2007-01-15

Patients with chronic conditions require frequent care visits. Problems can arise during several parts of the patient visit that decrease efficiency, making it difficult to effectively care for high volumes of patients. The purpose of the study is to test a method to improve patient visit efficiency. We used Patient Flow Analysis to identify inefficiencies in the patient visit, suggest areas for improvement, and test the effectiveness of clinic interventions. At baseline, the mean visit time for 93 anticoagulation clinic patient visits was 84 minutes (+/- 50 minutes) and the mean visit time for 25 chronic pain clinic patient visits was 65 minutes (+/- 21 minutes). Based on these data, we identified specific areas of inefficiency and developed interventions to decrease the mean time of the patient visit. After interventions, follow-up data found the mean visit time was reduced to 59 minutes (+/-25 minutes) for the anticoagulation clinic, a time decrease of 25 minutes (t-test 39%; p < 0.001). Mean visit time for the chronic pain clinic was reduced to 43 minutes (+/- 14 minutes) a time decrease of 22 minutes (t-test 34 %; p < 0.001). Patient Flow Analysis is an effective technique to identify inefficiencies in the patient visit and efficiently collect patient flow data. Once inefficiencies are identified they can be improved through brief interventions.

Impact of environmental production conditions on productivity and efficiency: a case study of wheat farmers in Bangladesh.

PubMed

Rahman, Sanzidur; Hasan, M Kamrul

2008-09-01

Environmental conditions significantly affect production, but are often ignored in studies analysing productivity and efficiency leading to biased results. In this study, we examine the influence of selected environmental factors on productivity and efficiency in wheat farming in Bangladesh. Results reveal that environmental production conditions significantly affect the parameters of the production function and technical efficiency, as well as correlates of inefficiency. Controlling for environmental production conditions improves technical efficiency by 4 points (p<0.01) from 86% to 90%. Large farms are more efficient relative to small and medium sized farms (p<0.01 and 0.05), with no variation among regions. Policy implications include soil fertility improvement through soil conservation and crop rotation, improvement in managerial practices through extension services and adoption of modern technologies, promotion of education, strengthening the research-extension link, and development of new varieties that have higher yield potential and are also suitable for marginal areas.

Efficiency measurement of the banking sector in the presence of non-performing loan

NASA Astrophysics Data System (ADS)

Hamid, Nurhayati; Ramli, Noor Asiah; Hussin, Siti Aida Sheikh

2017-01-01

Bank industry plays a vital role in a country's economic development. In the banking industry, the non-performing loans which are acknowledged as being undesirable outputs and usually ignored in most of the analysis should be taken into account since they are undesirable by-products of producing loans and may lead to the bank inefficiency. Modelling the efficiency measurement without undesirable outputs can provide misleading results and unfair assessment. The Directional Distance Function (DDF) approach which extended from the Data Envelopment Analysis (DEA) framework is one of the enhancement efficiency approaches to handle a situation when there is a joint production of the desirable and undesirable outputs. The comparison of both results between the domestic and foreign banks shows that the DEA technical efficiency score for domestic banks is marginally higher than the Malaysian foreign banks. However, when incorporating the undesirable output, the DDF technical efficiency for foreign banks is slightly higher than domestic banks.

Impact of HMO penetration and other environmental factors on hospital X-inefficiency.

PubMed

Rosko, M D

2001-12-01

This study examined the impact of health maintenance organization (HMO) market penetration and other internal and external environmental factors on hospital X-inefficiency in a national sample (N = 1,966) of urban U.S. hospitals in 1997. Stochastic frontier analysis, a frontier regression technique, was used to measure X-inefficiency and estimate parameters of the correlates of X-inefficiency. Log-likelihood restriction tests were used to test a variety of assumptions about the empirical model that guided its selection. Average estimated X-inefficiency in study hospitals was 12.96 percent. Increases in managed care penetration, dependence on Medicare and Medicaid, membership in a multihospital system, and location in areas where competitive pressures and the pool of uncompensated care are greater were associated with less X-inefficiency. Not-for-profit ownership was associated with increased X-inefficiency.

Value for money of changing healthcare services? Economic evaluation of quality improvement

PubMed Central

Severens, J

2003-01-01



 There are many instances of perceived or real inefficiencies in health service delivery. Both healthcare providers and policy makers need to know the impact and cost of applying strategies to change the behaviour of individuals or organisations. Quality improvement or implementation research is concerned with evaluating the methods of behavioural change. Addressing inefficiencies in healthcare services raises a series of issues, beginning with how inefficiency itself should be defined. The basic concepts of cost analysis and economic evaluations are explained and a model for working through the economic issues of quality improvement is discussed. This model combines the costs and benefits of corrected inefficiency with the costs and degree of behavioural change achieved by a quality improvement method in the policy maker's locality. It shows why it may not always be cost effective for policy makers to address suboptimal behaviour. Both the interpretation of quality improvement research findings and their local application need careful consideration. The limited availability of applicable quality improvement research may make it difficult to provide robust advice on the value for money of many behavioural quality improvement strategies. PMID:14532369

Technology Solutions Case Study: Balancing Hydronic Systems in Multifamily Buildings, Chicago, Illinois

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

2014-09-01

In multifamily building hydronic systems, temperature imbalance may be caused by undersized piping, improperly adjusted balancing valves, inefficient water temperature and flow levels, and owner/occupant interaction with the boilers, distribution and controls. The effects of imbalance include tenant discomfort, higher energy use intensity and inefficient building operation. In this case study , Partnership for Advanced Residential Retrofit and Elevate Energy. explores cost-effective distribution upgrades and balancing measures in multifamily hydronic systems, providing a resource to contractors, auditors, and building owners on best practices to improve tenant comfort and lower operating costs.

Cost efficiency of US hospitals: a stochastic frontier approach.

PubMed

Rosko, M D

2001-09-01

This study examined the impact of managed care and other environmental factors on hospital inefficiency in 1631 US hospitals during the period 1990-1996. A panel, stochastic frontier regression model was used to estimate inefficiency parameters and inefficiency scores. The results suggest that mean estimated inefficiency decreased by about 28% during the study period. Inefficiency was negatively associated with health maintenance organization (HMO) penetration and industry concentration. It was positively related with Medicare share and for-profit ownership status. Copyright 2001 John Wiley & Sons, Ltd.

Research on the identification of inefficient and invalid circulation in ultra-high water cut stage

NASA Astrophysics Data System (ADS)

Han, Shaoxin

2018-06-01

After oil field entered into ultra-high water cut stage, big channels are formed in some oil and water wells and lead to the inefficient and ineffective circulation of injected water, which not only inhibit the increase of recovery ratio of oil and gas, but also cause the waste of resources. This article selects three static parameters and four dynamic parameters which can perform inefficient and ineffective circulation characteristics between oil and water wells, integrates the fuzzy mathematics theory, establishes fuzzy comprehensive evaluation model to identify the inefficient and ineffective circulation wells in the research area, on this basis, inefficient and ineffective circulation position is further determined through the logging curve characteristics and logging ratio method, the identification of inefficient and ineffective circulation "determine well and layer" is achieved, and provide powerful basis for governance work of inefficient and ineffective circulation.

Analysis of space systems for the space disposal of nuclear waste follow-on study. Volume 2. Technical report

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

1982-01-01

Some of the conclusions reached as a result of this study are summarized. Waste form parameters for the reference cermet waste form are available only by analogy. Detail design of the waste payload would require determination of actual waste form properties. The billet configuration constraints for the cermet waste form limit the packing efficiency to slightly under 75% net volume. The effect of this packing inefficiency in reducing the net waste form per waste payload can be seen graphically. The cermet waste form mass per unit mass of waste payload is lower than that of the iodine waste form evenmore » though the cermet has a higher density (6.5 versus 5.5). This is because the lead iodide is cast achieving almost 100% efficiency in packing. This inefficiency in the packing of the cermet results in a 20% increase in number of flights which increases both cost and risk. Alternative systems for waste mixes requiring low flight rates (technetium-99, iodine-129) can make effective use of the existing 65K space transportation system in either single- or dual-launch scenarios. A comprehensive trade study would be required to select the optimum orbit transfer system for low-launch-rate systems. This study was not conducted as part of the present effort due to selection of the cermet waste form as the reference for the study. Several candidates look attractive for both single- and dual-launch systems (see sec. 4.4), but due to the relatively small number of missions, a comprehensive comparison of life cycle costs including DDT and E would be required to select the best system. The reference system described in sections 5.0, 6.0, 7.0, and 8.0 offers the best combination of cost, risk, and alignment with ongoing NASA technology development efforts for disposal of the reference cermet waste form.« less

Study of the Relevance of the Quality of Care, Operating Efficiency and Inefficient Quality Competition of Senior Care Facilities.

PubMed

Lin, Jwu-Rong; Chen, Ching-Yu; Peng, Tso-Kwei

2017-09-11

The purpose of this research is to examine the relation between operating efficiency and the quality of care of senior care facilities. We designed a data envelopment analysis, combining epsilon-based measure and metafrontier efficiency analyses to estimate the operating efficiency for senior care facilities, followed by an iterative seemingly unrelated regression to evaluate the relation between the quality of care and operating efficiency. In the empirical studies, Taiwan census data was utilized and findings include the following: Despite the greater operating scale of the general type of senior care facilities, their average metafrontier technical efficiency is inferior to that of nursing homes. We adopted senior care facility accreditation results from Taiwan as a variable to represent the quality of care and examined the relation of accreditation results and operating efficiency. We found that the quality of care of general senior care facilities is negatively related to operating efficiency; however, for nursing homes, the relationship is not significant. Our findings show that facilities invest more in input resources to obtain better ratings in the accreditation report. Operating efficiency, however, does not improve. Quality competition in the industry in Taiwan is inefficient, especially for general senior care facilities.

A META-COMPOSITE SOFTWARE DEVELOPMENT APPROACH FOR TRANSLATIONAL RESEARCH

PubMed Central

Sadasivam, Rajani S.; Tanik, Murat M.

2013-01-01

Translational researchers conduct research in a highly data-intensive and continuously changing environment and need to use multiple, disparate tools to achieve their goals. These researchers would greatly benefit from meta-composite software development or the ability to continuously compose and recompose tools together in response to their ever-changing needs. However, the available tools are largely disconnected, and current software approaches are inefficient and ineffective in their support for meta-composite software development. Building on the composite services development approach, the de facto standard for developing integrated software systems, we propose a concept-map and agent-based meta-composite software development approach. A crucial step in composite services development is the modeling of users’ needs as processes, which can then be specified in an executable format for system composition. We have two key innovations. First, our approach allows researchers (who understand their needs best) instead of technicians to take a leadership role in the development of process models, reducing inefficiencies and errors. A second innovation is that our approach also allows for modeling of complex user interactions as part of the process, overcoming the technical limitations of current tools. We demonstrate the feasibility of our approach using a real-world translational research use case. We also present results of usability studies evaluating our approach for future refinements. PMID:23504436

A meta-composite software development approach for translational research.

PubMed

Sadasivam, Rajani S; Tanik, Murat M

2013-06-01

Translational researchers conduct research in a highly data-intensive and continuously changing environment and need to use multiple, disparate tools to achieve their goals. These researchers would greatly benefit from meta-composite software development or the ability to continuously compose and recompose tools together in response to their ever-changing needs. However, the available tools are largely disconnected, and current software approaches are inefficient and ineffective in their support for meta-composite software development. Building on the composite services development approach, the de facto standard for developing integrated software systems, we propose a concept-map and agent-based meta-composite software development approach. A crucial step in composite services development is the modeling of users' needs as processes, which can then be specified in an executable format for system composition. We have two key innovations. First, our approach allows researchers (who understand their needs best) instead of technicians to take a leadership role in the development of process models, reducing inefficiencies and errors. A second innovation is that our approach also allows for modeling of complex user interactions as part of the process, overcoming the technical limitations of current tools. We demonstrate the feasibility of our approach using a real-world translational research use case. We also present results of usability studies evaluating our approach for future refinements.

Study of the Relevance of the Quality of Care, Operating Efficiency and Inefficient Quality Competition of Senior Care Facilities

PubMed Central

Lin, Jwu-Rong; Chen, Ching-Yu; Peng, Tso-Kwei

2017-01-01

The purpose of this research is to examine the relation between operating efficiency and the quality of care of senior care facilities. We designed a data envelopment analysis, combining epsilon-based measure and metafrontier efficiency analyses to estimate the operating efficiency for senior care facilities, followed by an iterative seemingly unrelated regression to evaluate the relation between the quality of care and operating efficiency. In the empirical studies, Taiwan census data was utilized and findings include the following: Despite the greater operating scale of the general type of senior care facilities, their average metafrontier technical efficiency is inferior to that of nursing homes. We adopted senior care facility accreditation results from Taiwan as a variable to represent the quality of care and examined the relation of accreditation results and operating efficiency. We found that the quality of care of general senior care facilities is negatively related to operating efficiency; however, for nursing homes, the relationship is not significant. Our findings show that facilities invest more in input resources to obtain better ratings in the accreditation report. Operating efficiency, however, does not improve. Quality competition in the industry in Taiwan is inefficient, especially for general senior care facilities. PMID:28892019

Exergy: its potential and limitations in environmental science and technology.

PubMed

Dewulf, Jo; Van Langenhove, Herman; Muys, Bart; Bruers, Stijn; Bakshi, Bhavik R; Grubb, Geoffrey F; Paulus, D M; Sciubba, Enrico

2008-04-01

New technologies, either renewables-based or not, are confronted with both economic and technical constraints. Their development takes advantage of considering the basic laws of economics and thermodynamics. With respect to the latter, the exergy concept pops up. Although its fundamentals, that is, the Second Law of Thermodynamics, were already established in the 1800s, it is only in the last years that the exergy concept has gained a more widespread interest in process analysis, typically employed to identify inefficiencies. However, exergy analysis today is implemented far beyond technical analysis; it is also employed in environmental, (thermo)economic, and even sustainability analysis of industrial systems. Because natural ecosystems are also subjected to the basic laws of thermodynamics, it is another subject of exergy analysis. After an introduction on the concept itself, this review focuses on the potential and limitations of the exergy conceptin (1) ecosystem analysis, utilized to describe maximum storage and maximum dissipation of energy flows (2); industrial system analysis: from single process analysis to complete process chain analysis (3); (thermo)economic analysis, with extended exergy accounting; and (4) environmental impact assessment throughout the whole life cycle with quantification of the resource intake and emission effects. Apart from technical system analysis, it proves that exergy as a tool in environmental impact analysis may be the most mature field of application, particularly with respect to resource and efficiency accounting, one of the major challenges in the development of sustainable technology. Far less mature is the exergy analysis of natural ecosystems and the coupling with economic analysis, where a lively debate is presently going on about the actual merits of an exergy-based approach.

An efficient start-up circuitry for de-energized ultra-low power energy harvesting systems

NASA Astrophysics Data System (ADS)

Hörmann, Leander B.; Berger, Achim; Salzburger, Lukas; Priller, Peter; Springer, Andreas

2015-05-01

Cyber-physical systems often include small wireless devices to measure physical quantities or control a technical process. These devices need a self-sufficient power supply because no wired infrastructure is available. Their operational time can be enhanced by energy harvesting systems. However, the convertible power is often limited and discontinuous which requires the need of an energy storage unit. If this unit (and thus the whole system) is de-energized, the start-up process may take a significant amount of time because of an inefficient energy harvesting process. Therefore, this paper presents a system which enables a safe and fast start-up from the de-energized state.

Quantifying short run cost-effectiveness during a gradual implementation process.

PubMed

van de Wetering, Gijs; Woertman, Willem H; Verbeek, Andre L; Broeders, Mireille J; Adang, Eddy M M

2013-12-01

This paper examines the short run inefficiencies that arise during gradual implementation of a new cost-effective technology in healthcare. These inefficiencies arise when health gains associated with the new technology cannot be obtained immediately because the new technology does not yet supply all patients, and when there is overcapacity for the old technology in the short run because the supply of care is divided among two mutually exclusive technologies. Such efficiency losses are not taken into account in standard textbook cost-effectiveness analysis in which a steady state is presented where costs and effects are assumed to be unchanging over time. A model is constructed to quantify such short run inefficiencies as well as to inform the decision maker about the optimal implementation pattern for the new technology. The model operates by integrating the incremental net benefit equations for both the period of co-existence of mutually exclusive technologies and the period after complete substitution of the old technology. It takes into account the rate of implementation of the new technology, depreciation of capital of the old technology as well as the demand curves for both technologies. The model is applied to the real world case of converting from screen film to digital mammography in the Netherlands.

Ten Steps to Establishing an e-Consultation Service to Improve Access to Specialist Care

PubMed Central

Maranger, Julie; Afkham, Amir; Keely, Erin

2013-01-01

Abstract There is dissatisfaction among primary care physicians, specialists, and patients with respect to the consultation process. Excessive wait times for receiving specialist services and inefficient communication between practitioners result in decreased access to care and jeopardize patient safety. We created and implemented an electronic consultation (e-consultation) system in Eastern Ontario to address these problems and improve the consultation process. The e-consultation system has passed through the proof-of-concept and pilot study stages and has effectively reduced unnecessary referrals while receiving resoundingly positive feedback from physician-users. Using our experience, we have outlined the 10 steps to developing an e-consultation service. We detail the technical, administrative, and strategic considerations with respect to (1) identifying your partners, (2) choosing your platform, (3) starting as a pilot project, (4) designing your product, (5) ensuring patient privacy, (6) thinking through the process, (7) fostering relationships with your participants, (8) being prepared to provide physician payment, (9) providing feedback, and (10) planning the transition from pilot to permanency. In following these 10 steps, we believe that the e-consultation system and its associated improvements on the consultation process can be effectively implemented in other healthcare settings. PMID:24073898

More nonlocality with less entanglement in Clauser-Horne-Shimony-Holt experiments using inefficient detectors

NASA Astrophysics Data System (ADS)

Dilley, Daniel; Chitambar, Eric

2018-06-01

It is well-known that in certain scenarios weakly entangled states can generate stronger nonlocal effects than their maximally entangled counterparts. In this paper, we consider violations of the Clauser-Horne-Shimony-Holt (CHSH) inequality when one party has inefficient detectors, a scenario known as an asymmetric Bell experiment. For any fixed detection efficiency, we derive a simple upper bound on the entanglement needed to violate the inequality by more than some specified amount κ ≥0 . When κ =0 , the amount of entanglement in all states violating the inequality goes to zero as the detection efficiency approaches 50 % from above. We finally consider the scenario in which detection inefficiency arises for only one choice of local measurement. In this case, it is shown that the CHSH inequality can always be violated for any nonzero detection efficiency and any choice of noncommuting measurements.

Training on women and renewable sources of energy.

PubMed

Duenas Loza, M

1997-01-01

The training package developed by the International Research and Training Institute for the Advancement of Women in 1989 focuses on women and energy. The Institute conducts training activities using collected, analyzed and disseminated information and documentation, as well as identification of critical research and training activities and promotion of integrated issues on women and energy policies, programs and projects. Previous training experiences identified the inefficient quality of training offered to community members, technical staff and technical agencies, with more emphasis on the technical skills instead on the managerial, socio-organizational and environmental aspects. The creation of a multimedia modular training material provides an association between the issues of women, New and Renewable Sources of Energy (NRSE) and environmental aspects necessary for the strengthening of national institutions, promotion of socioeconomical and technically feasible renewable technologies, and awareness building, information and communication enhancement. The package covers 1) overview of the UN activities on NRSE; 2) Women's Position in the Energy Sector; 3) NRSE Project and Program design and implementation; 4) relevant NRSE characteristics and technology systems; 5) education and training activities in NRSE projects. This training package is designed to contribute a new approach in the organization and management of NRSE through integration of women's needs and increase awareness and capabilities of planners, officials and experts. In addition, several training seminars were conducted during 1989-91, which focused on the relationship between women and renewable energy sources through the application of participatory and self-reliant techniques.

Voluntary medical male circumcision scale-up in Nyanza, Kenya: evaluating technical efficiency and productivity of service delivery.

PubMed

Omondi Aduda, Dickens S; Ouma, Collins; Onyango, Rosebella; Onyango, Mathews; Bertrand, Jane

2015-01-01

Voluntary medical male circumcision (VMMC) service delivery is complex and resource-intensive. In Kenya's context there is still paucity of information on resource use vis-à-vis outputs as programs scale up. Knowledge of technical efficiency, productivity and potential sources of constraints is desirable to improve decision-making. To evaluate technical efficiency and productivity of VMMC service delivery in Nyanza in 2011/2012 using data envelopment analysis. Comparative process evaluation of facilities providing VMMC in Nyanza in 2011/2012 using output orientated data envelopment analysis. Twenty one facilities were evaluated. Only 1 of 7 variables considered (total elapsed operation time) significantly improved from 32.8 minutes (SD 8.8) in 2011 to 30 minutes (SD 6.6) in 2012 (95%CI = 0.0350-5.2488; p = 0.047). Mean scale technical efficiency significantly improved from 91% (SD 19.8) in 2011 to 99% (SD 4.0) in 2012 particularly among outreach compared to fixed service delivery facilities (CI -31.47959-4.698508; p = 0.005). Increase in mean VRS technical efficiency from 84% (SD 25.3) in 2011 and 89% (SD 25.1) in 2012 was not statistically significant. Benchmark facilities were #119 and #125 in 2011 and #103 in 2012. Malmquist Productivity Index (MPI) at fixed facilities declined by 2.5% but gained by 4.9% at outreach ones by 2012. Total factor productivity improved by 83% (p = 0.032) in 2012, largely due to progress in technological efficiency by 79% (p = 0.008). Significant improvement in scale technical efficiency among outreach facilities in 2012 was attributable to accelerated activities. However, ongoing pure technical inefficiency requires concerted attention. Technological progress was the key driver of service productivity growth in Nyanza. Incorporating service-quality dimensions and using stepwise-multiple criteria in performance evaluation enhances comprehensiveness and validity. These findings highlight site-level resource use and sources of variations in VMMC service productivity, which are important for program planning.

Investigating the Epigenetic Discrimination of Identical Twins Using Buccal Swabs, Saliva, and Cigarette Butts in the Forensic Setting.

PubMed

Vidaki, Athina; Kalamara, Vivian; Carnero-Montoro, Elena; Spector, Timothy D; Bell, Jordana T; Kayser, Manfred

2018-05-14

Monozygotic (MZ) twins are typically indistinguishable via forensic DNA profiling. Recently, we demonstrated that epigenetic differentiation of MZ twins is feasible; however, proportions of twin differentially methylated CpG sites (tDMSs) identified in reference-type blood DNA were not replicated in trace-type blood DNA. Here we investigated buccal swabs as typical forensic reference material, and saliva and cigarette butts as commonly encountered forensic trace materials. As an analog to a forensic case, we analyzed one MZ twin pair. Epigenome-wide microarray analysis in reference-type buccal DNA revealed 25 candidate tDMSs with >0.5 twin-to-twin differences. MethyLight quantitative PCR (qPCR) of 22 selected tDMSs in trace-type DNA revealed in saliva DNA that six tDMSs (27.3%) had >0.1 twin-to-twin differences, seven (31.8%) had smaller (<0.1) but robustly detected differences, whereas for nine (40.9%) the differences were in the opposite direction relative to the microarray data; for cigarette butt DNA, results were 50%, 22.7%, and 27.3%, respectively. The discrepancies between reference-type and trace-type DNA outcomes can be explained by cell composition differences, method-to-method variation, and other technical reasons including bisulfite conversion inefficiency. Our study highlights the importance of the DNA source and that careful characterization of biological and technical effects is needed before epigenetic MZ twin differentiation is applicable in forensic casework.

Health care in the CIS countries : the case of hospitals in Ukraine.

PubMed

Pilyavsky, Anatoly; Staat, Matthias

2006-09-01

The study analyses the technical efficiency of community hospitals in Ukraine during 1997-2001. Hospital cost amount to two-thirds of Ukrainian spending on health care. Data are available on the number of beds, physicians and nurses employed, surgical procedures performed, and admissions and patient days. We employ data envelopment analysis to calculate the efficiency of hospitals and to assess productivity changes over time. The scores calculated with an output-oriented model assuming constant returns to scale range from 150% to 110%. Average relative inefficiency of the hospitals is initially above 30% and later drops to 15% or below. The average productivity change is positive but below 1%; a Malmquist index decomposition reveals that negative technological progress is overcompensated by positive catching-up.

Multiplexed droplet single-cell RNA-sequencing using natural genetic variation.

PubMed

Kang, Hyun Min; Subramaniam, Meena; Targ, Sasha; Nguyen, Michelle; Maliskova, Lenka; McCarthy, Elizabeth; Wan, Eunice; Wong, Simon; Byrnes, Lauren; Lanata, Cristina M; Gate, Rachel E; Mostafavi, Sara; Marson, Alexander; Zaitlen, Noah; Criswell, Lindsey A; Ye, Chun Jimmie

2018-01-01

Droplet single-cell RNA-sequencing (dscRNA-seq) has enabled rapid, massively parallel profiling of transcriptomes. However, assessing differential expression across multiple individuals has been hampered by inefficient sample processing and technical batch effects. Here we describe a computational tool, demuxlet, that harnesses natural genetic variation to determine the sample identity of each droplet containing a single cell (singlet) and detect droplets containing two cells (doublets). These capabilities enable multiplexed dscRNA-seq experiments in which cells from unrelated individuals are pooled and captured at higher throughput than in standard workflows. Using simulated data, we show that 50 single-nucleotide polymorphisms (SNPs) per cell are sufficient to assign 97% of singlets and identify 92% of doublets in pools of up to 64 individuals. Given genotyping data for each of eight pooled samples, demuxlet correctly recovers the sample identity of >99% of singlets and identifies doublets at rates consistent with previous estimates. We apply demuxlet to assess cell-type-specific changes in gene expression in 8 pooled lupus patient samples treated with interferon (IFN)-β and perform eQTL analysis on 23 pooled samples.

Reducing Postharvest Losses during Storage of Grain Crops to Strengthen Food Security in Developing Countries.

PubMed

Kumar, Deepak; Kalita, Prasanta

2017-01-15

While fulfilling the food demand of an increasing population remains a major global concern, more than one-third of food is lost or wasted in postharvest operations. Reducing the postharvest losses, especially in developing countries, could be a sustainable solution to increase food availability, reduce pressure on natural resources, eliminate hunger and improve farmers' livelihoods. Cereal grains are the basis of staple food in most of the developing nations, and account for the maximum postharvest losses on a calorific basis among all agricultural commodities. As much as 50%-60% cereal grains can be lost during the storage stage due only to the lack of technical inefficiency. Use of scientific storage methods can reduce these losses to as low as 1%-2%. This paper provides a comprehensive literature review of the grain postharvest losses in developing countries, the status and causes of storage losses and discusses the technological interventions to reduce these losses. The basics of hermetic storage, various technology options, and their effectiveness on several crops in different localities are discussed in detail.

Reducing Postharvest Losses during Storage of Grain Crops to Strengthen Food Security in Developing Countries

PubMed Central

Kumar, Deepak; Kalita, Prasanta

2017-01-01

While fulfilling the food demand of an increasing population remains a major global concern, more than one-third of food is lost or wasted in postharvest operations. Reducing the postharvest losses, especially in developing countries, could be a sustainable solution to increase food availability, reduce pressure on natural resources, eliminate hunger and improve farmers’ livelihoods. Cereal grains are the basis of staple food in most of the developing nations, and account for the maximum postharvest losses on a calorific basis among all agricultural commodities. As much as 50%–60% cereal grains can be lost during the storage stage due only to the lack of technical inefficiency. Use of scientific storage methods can reduce these losses to as low as 1%–2%. This paper provides a comprehensive literature review of the grain postharvest losses in developing countries, the status and causes of storage losses and discusses the technological interventions to reduce these losses. The basics of hermetic storage, various technology options, and their effectiveness on several crops in different localities are discussed in detail. PMID:28231087

Network embedding-based representation learning for single cell RNA-seq data.

PubMed

Li, Xiangyu; Chen, Weizheng; Chen, Yang; Zhang, Xuegong; Gu, Jin; Zhang, Michael Q

2017-11-02

Single cell RNA-seq (scRNA-seq) techniques can reveal valuable insights of cell-to-cell heterogeneities. Projection of high-dimensional data into a low-dimensional subspace is a powerful strategy in general for mining such big data. However, scRNA-seq suffers from higher noise and lower coverage than traditional bulk RNA-seq, hence bringing in new computational difficulties. One major challenge is how to deal with the frequent drop-out events. The events, usually caused by the stochastic burst effect in gene transcription and the technical failure of RNA transcript capture, often render traditional dimension reduction methods work inefficiently. To overcome this problem, we have developed a novel Single Cell Representation Learning (SCRL) method based on network embedding. This method can efficiently implement data-driven non-linear projection and incorporate prior biological knowledge (such as pathway information) to learn more meaningful low-dimensional representations for both cells and genes. Benchmark results show that SCRL outperforms other dimensional reduction methods on several recent scRNA-seq datasets. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.

Technical efficiency and resources allocation in university hospitals in Tehran, 2009-2012.

PubMed

Rezapour, Aziz; Ebadifard Azar, Farbod; Yousef Zadeh, Negar; Roumiani, YarAllah; Bagheri Faradonbeh, Saeed

2015-01-01

Assessment of hospitals' performance in achieving its goals is a basic necessity. Measuring the efficiency of hospitals in order to boost resource productivity in healthcare organizations is extremely important. The aim of this study was to measure technical efficiency and determining status of resource allocation in some university hospitals, in Tehran, Iran. This study was conducted in 2012; the research population consisted of all hospitals affiliated to Iran and Tehran medical sciences universities of. Required data, such as human and capital resources information and also production variables (hospital outputs) were collected from data centers of studied hospitals. Data were analyzed using data envelopment analysis (DEA) method, Deap2,1 software; and the stochastic frontier analysis (SFA) method, Frontier 4,1 software. According to DEA method, average of technical, management (pure) and scale efficiency of the studied hospitals during the study period were calculated 0.87, 0.971, and 0.907, respectively. All kinds of efficiency did not follow a fixed trend over the study time and were constantly changing. In the stochastic frontier's production function analysis, the technical efficiency of the studied industry during the study period was estimated to be 0.389. This study represented hospitals with the highest and lowest efficiency. Reference hospitals (more efficient states) were indicated for the inefficient centers. According to the findings, it was found that in the hospitals that do not operate efficiently, there is a capacity to improve the technical efficiency by removing excess inputs without changes in the level of outputs. However, by the optimal allocation of resources in most studied hospitals, very important economy of scale can be achieved.

Technical efficiency and resources allocation in university hospitals in Tehran, 2009-2012

PubMed Central

Rezapour, Aziz; Ebadifard Azar, Farbod; Yousef Zadeh, Negar; Roumiani, YarAllah; Bagheri Faradonbeh, Saeed

2015-01-01

Background: Assessment of hospitals’ performance in achieving its goals is a basic necessity. Measuring the efficiency of hospitals in order to boost resource productivity in healthcare organizations is extremely important. The aim of this study was to measure technical efficiency and determining status of resource allocation in some university hospitals, in Tehran, Iran. Methods: This study was conducted in 2012; the research population consisted of all hospitals affiliated to Iran and Tehran medical sciences universities of. Required data, such as human and capital resources information and also production variables (hospital outputs) were collected from data centers of studied hospitals. Data were analyzed using data envelopment analysis (DEA) method, Deap2,1 software; and the stochastic frontier analysis (SFA) method, Frontier 4,1 software. Results: According to DEA method, average of technical, management (pure) and scale efficiency of the studied hospitals during the study period were calculated 0.87, 0.971, and 0.907, respectively. All kinds of efficiency did not follow a fixed trend over the study time and were constantly changing. In the stochastic frontier's production function analysis, the technical efficiency of the studied industry during the study period was estimated to be 0.389. Conclusion: This study represented hospitals with the highest and lowest efficiency. Reference hospitals (more efficient states) were indicated for the inefficient centers. According to the findings, it was found that in the hospitals that do not operate efficiently, there is a capacity to improve the technical efficiency by removing excess inputs without changes in the level of outputs. However, by the optimal allocation of resources in most studied hospitals, very important economy of scale can be achieved. PMID:26793657

The Emergence of Network Inefficiencies in Infants With Autism Spectrum Disorder.

PubMed

Lewis, John D; Evans, Alan C; Pruett, John R; Botteron, Kelly N; McKinstry, Robert C; Zwaigenbaum, Lonnie; Estes, Annette M; Collins, D Louis; Kostopoulos, Penelope; Gerig, Guido; Dager, Stephen R; Paterson, Sarah; Schultz, Robert T; Styner, Martin A; Hazlett, Heather C; Piven, Joseph

2017-08-01

Autism spectrum disorder (ASD) is a developmental disorder defined by behavioral features that emerge during the first years of life. Research indicates that abnormalities in brain connectivity are associated with these behavioral features. However, the inclusion of individuals past the age of onset of the defining behaviors complicates interpretation of the observed abnormalities: they may be cascade effects of earlier neuropathology and behavioral abnormalities. Our recent study of network efficiency in a cohort of 24-month-olds at high and low familial risk for ASD reduced this confound; we reported reduced network efficiencies in toddlers classified with ASD. The current study maps the emergence of these inefficiencies in the first year of life. This study uses data from 260 infants at 6 and 12 months of age, including 116 infants with longitudinal data. As in our earlier study, we use diffusion data to obtain measures of the length and strength of connections between brain regions to compute network efficiency. We assess group differences in efficiency within linear mixed-effects models determined by the Akaike information criterion. Inefficiencies in high-risk infants later classified with ASD were detected from 6 months onward in regions involved in low-level sensory processing. In addition, within the high-risk infants, these inefficiencies predicted 24-month symptom severity. These results suggest that infants with ASD, even before 6 months of age, have deficits in connectivity related to low-level processing, which contribute to a developmental cascade affecting brain organization and eventually higher-level cognitive processes and social behavior. Copyright © 2017 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Controlling costs without compromising quality: paying hospitals for total knee replacement.

PubMed

Pine, Michael; Fry, Donald E; Jones, Barbara L; Meimban, Roger J; Pine, Gregory J

2010-10-01

Unit costs of health services are substantially higher in the United States than in any other developed country in the world, without a correspondingly healthier population. An alternative payment structure, especially for high volume, high cost episodes of care (eg, total knee replacement), is needed to reward high quality care and reduce costs. The National Inpatient Sample of administrative claims data was used to measure risk-adjusted mortality, postoperative length-of-stay, costs of routine care, adverse outcome rates, and excess costs of adverse outcomes for total knee replacements performed between 2002 and 2005. Empirically identified inefficient and ineffective hospitals were then removed to create a reference group of high-performance hospitals. Predictive models for outcomes and costs were recalibrated to the reference hospitals and used to compute risk-adjusted outcomes and costs for all hospitals. Per case predicted costs were computed and compared with observed costs. Of the 688 hospitals with acceptable data, 62 failed to meet effectiveness criteria and 210 were identified as inefficient. The remaining 416 high-performance hospitals had 13.4% fewer risk-adjusted adverse outcomes (4.56%-3.95%; P < 0.001; χ) and 9.9% lower risk-adjusted total costs ($12,773-$11,512; P < 0.001; t test) than all study hospitals. Inefficiency accounted for 96% of excess costs. A payment system based on the demonstrated performance of effective, efficient hospitals can produce sizable cost savings without jeopardizing quality. In this study, 96% of total excess hospital costs resulted from higher routine costs at inefficient hospitals, whereas only 4% was associated with ineffective care.

Mobile radiography CQI: an inter-national study.

PubMed

Kamat, M R; Wein, B; Cohan, R

1999-01-01

Mobile or bedside radiography has been and is a staple diagnostic and follow-up tool used readily by the many medical disciplines, such as cardiology, surgery, orthopedics, pediatrics, neonatology, etc. Ironically, in the past a student or the least qualified technologist was sent to perform the bedside exam. Moreover, it was almost expected that poor but acceptable film quality would result or that repeat films were almost always to be taken. Inefficiency with respect to quality of exam, the time the exam takes, or film repeats can be costly. The price of inefficiency is the cost involved in doing things incorrectly or not in the most efficient manner, i.e., incurring inefficiencies instead of operating in an ideal manner. The purpose of this study was to compare the total cost of inefficiently organized, scheduled and performed mobile radiography at three large teaching hospitals in various locations and of diverse patient loads, as a means of determining how best to increase utilization and performance. The study was performed at the 489-bed New England Deaconess Hospital (NEDH), the 644-bed Sentara Norfolk General Hospital (SNGH), and the 1500-bed Rheinische Westfalische Technische Hochschule (RWTH) in Aachen, Germany. Similar standardized study methods were utilized at all three institutions where extended observation of mobile utilization, areas of inefficiency, time wasted per episode and number of episodes per time period were determined. Data were loggedin at three standardized time periods, summated, and then multiplied by technologist hourly pay rate. This sum was extrapolated over 52 weeks to give the total annual cost of inefficiently organized mobile radiography. For NEDH the cost of total inefficiency was $75,453, for SNGH $49,586, while for RWTH it was $9,519. Eighteen areas of inefficiency were identified and grouped, such as lack of spatial cohesiveness and lack of communication leading to film duplication, etc. While inefficiencies in the delivery of hospital based health care are well known, this study attempts to quantify and determine a dollar value for each process found as inefficient. Key inefficiencies were found to be common at large hospitals no matter whether in the United States or Europe. These impairments are responsible for a disproportionate share of overall inefficiency, and their elimination (achievable by simple solutions) would result in drastic cost reductions (ranging from 40-75% at the institutions studied). Thus this study is important in view of spiralling costs, as it is a key component of total quality management (TQM) in radiology and a continuous quality improvement (CQI) tool for mobile radiology specifically.

Kinky thresholds revisited: opportunity costs differ in the NE and SW quadrants.

PubMed

Eckermann, Simon

2015-02-01

Historically, a kinked threshold line on the cost-effectiveness plane at the origin was suggested due to differences in willingness to pay (WTP) for health gain with trade-offs in the north-east (NE) quadrant versus willingness to accept (WTA) cost reductions for health loss with trade-offs in the south-west (SW) quadrant. Empirically, WTA is greater than WTP for equivalent units of health, a finding supported by loss aversion under prospect theory. More recently, appropriate threshold values for health effects have been shown to require an endogenous consideration of the opportunity cost of alternative actions in budget-constrained health systems, but also allocative and displacement inefficiency observed in health system practice. Allocative and displacement inefficiency arise in health systems where the least cost-effective program in contraction has a higher incremental cost-effectiveness ratio (ICER = m) than the most cost-effective program in expansion (ICER = n) and displaced services (ICER = d), respectively. The health shadow price derived by Pekarsky, [Formula: see text] reflects the opportunity cost of best alternative adoption and financing actions in reimbursing new technology with expected incremental costs and net effect allowing for allocative (n < m), and displacement, inefficiency (d < m). This provides an appropriate threshold value for the NE quadrant. In this paper, I show that for trade-offs in the SW quadrant, where new strategies have lower expected net cost while lower expected net effect than current practice, the opportunity cost is contraction of the least cost-effective program, with threshold ICER m. That is, in the SW quadrant, the cost reduction per unit of decreased effect should be compared with the appropriate opportunity cost, best alternative generation of funding. Consequently, appropriate consideration of opportunity cost produces a kink in the threshold at the origin, with the health shadow price in the NE quadrant and ICER of the least cost-effective program in contraction (m) in the SW quadrant having the same general shape as that previously suggested by WTP versus WTA. The extent of this kink depends on the degree of allocative and displacement inefficiency, with no kink in the threshold line strictly only appropriate with complete allocative and displacement efficiency, that is n = d = m.

Social learning strategies modify the effect of network structure on group performance.

PubMed

Barkoczi, Daniel; Galesic, Mirta

2016-10-07

The structure of communication networks is an important determinant of the capacity of teams, organizations and societies to solve policy, business and science problems. Yet, previous studies reached contradictory results about the relationship between network structure and performance, finding support for the superiority of both well-connected efficient and poorly connected inefficient network structures. Here we argue that understanding how communication networks affect group performance requires taking into consideration the social learning strategies of individual team members. We show that efficient networks outperform inefficient networks when individuals rely on conformity by copying the most frequent solution among their contacts. However, inefficient networks are superior when individuals follow the best member by copying the group member with the highest payoff. In addition, groups relying on conformity based on a small sample of others excel at complex tasks, while groups following the best member achieve greatest performance for simple tasks. Our findings reconcile contradictory results in the literature and have broad implications for the study of social learning across disciplines.

Social learning strategies modify the effect of network structure on group performance

NASA Astrophysics Data System (ADS)

Barkoczi, Daniel; Galesic, Mirta

2016-10-01

The structure of communication networks is an important determinant of the capacity of teams, organizations and societies to solve policy, business and science problems. Yet, previous studies reached contradictory results about the relationship between network structure and performance, finding support for the superiority of both well-connected efficient and poorly connected inefficient network structures. Here we argue that understanding how communication networks affect group performance requires taking into consideration the social learning strategies of individual team members. We show that efficient networks outperform inefficient networks when individuals rely on conformity by copying the most frequent solution among their contacts. However, inefficient networks are superior when individuals follow the best member by copying the group member with the highest payoff. In addition, groups relying on conformity based on a small sample of others excel at complex tasks, while groups following the best member achieve greatest performance for simple tasks. Our findings reconcile contradictory results in the literature and have broad implications for the study of social learning across disciplines.

Locating inefficient links in a large-scale transportation network

NASA Astrophysics Data System (ADS)

Sun, Li; Liu, Like; Xu, Zhongzhi; Jie, Yang; Wei, Dong; Wang, Pu

2015-02-01

Based on data from geographical information system (GIS) and daily commuting origin destination (OD) matrices, we estimated the distribution of traffic flow in the San Francisco road network and studied Braess's paradox in a large-scale transportation network with realistic travel demand. We measured the variation of total travel time Δ T when a road segment is closed, and found that | Δ T | follows a power-law distribution if Δ T < 0 or Δ T > 0. This implies that most roads have a negligible effect on the efficiency of the road network, while the failure of a few crucial links would result in severe travel delays, and closure of a few inefficient links would counter-intuitively reduce travel costs considerably. Generating three theoretical networks, we discovered that the heterogeneously distributed travel demand may be the origin of the observed power-law distributions of | Δ T | . Finally, a genetic algorithm was used to pinpoint inefficient link clusters in the road network. We found that closing specific road clusters would further improve the transportation efficiency.

Cultural differences in the imitation and transmission of inefficient actions.

PubMed

Corriveau, Kathleen H; DiYanni, Cara J; Clegg, Jennifer M; Min, Grace; Chin, Jason; Nasrini, Jad

2017-09-01

Across two studies, we explored cultural differences in children's imitation and transmission of inefficient actions. Chinese American and Caucasian American preschoolers (N=115) viewed either one or three models using two inefficient tools to perform two different tasks. In the video, when the model(s) performed the task, only the inefficient tool was available; thus, their choice to use that tool could be considered rational. Next, children were invited to complete the task with either the inefficient tool or an efficient alternative. Whereas the two cultural groups imitated a single model at similar rates, Chinese American children imitated significantly more than Caucasian American children after viewing a consensus. Similar results were found when exploring differences in information transmission. The Chinese American children were significantly more likely than their Caucasian American peers to instruct using an inefficient tool when they had initially viewed a consensus demonstrate it. We discuss these findings with respect to differences in children's use of social versus task-specific cues for learning and teaching. Copyright © 2017 Elsevier Inc. All rights reserved.

Persistent and transient cost efficiency—an application to the Swiss hydropower sector

DOE PAGES

Filippini, Massimo; Geissmann, Thomas; Greene, William H.

2017-11-27

Electricity prices on the European market have decreased significantly over the past few years, resulting in a deterioration of Swiss hydropower firms’ competitiveness and profitability. One option to improve the sector’s competitiveness is to increase cost efficiency. The goal of this study is to quantify the level of persistent and transient cost efficiency of individual firms by applying the generalized true random effects (GTRE) model introduced by Colombi et al. (Journal of Productivity Analysis 42(2): 123–136, 2014) and Filippini and Greene (Journal of Productivity Analysis 45(2): 187–196, 2016). Applying this newly developed GTRE model to a total cost function, themore » level of cost efficiency of 65 Swiss hydropower firms is analyzed for the period between 2000 and 2013. A true random effects specification is estimated as a benchmark for the transient level of cost efficiency. The results show the presence of both transient as well as persistent cost inefficiencies. The GTREM predicts the aggregate level of cost inefficiency to amount to 21.8% (8.0% transient, 13.8% persistent) on average between 2000 and 2013. These two components differ in interpretation and implication. From an individual firm’s perspective, the two types of cost inefficiencies might require a firm’s management to respond with different improvement strategies. The existing level of persistent inefficiency could prevent the hydropower firms from adjusting their production processes to new market environments. From a regulatory point of view, the results of this study could be used in the scope and determination of the amount of financial support given to struggling firms.« less

Persistent and transient cost efficiency—an application to the Swiss hydropower sector

DOE Office of Scientific and Technical Information (OSTI.GOV)

Filippini, Massimo; Geissmann, Thomas; Greene, William H.

Electricity prices on the European market have decreased significantly over the past few years, resulting in a deterioration of Swiss hydropower firms’ competitiveness and profitability. One option to improve the sector’s competitiveness is to increase cost efficiency. The goal of this study is to quantify the level of persistent and transient cost efficiency of individual firms by applying the generalized true random effects (GTRE) model introduced by Colombi et al. (Journal of Productivity Analysis 42(2): 123–136, 2014) and Filippini and Greene (Journal of Productivity Analysis 45(2): 187–196, 2016). Applying this newly developed GTRE model to a total cost function, themore » level of cost efficiency of 65 Swiss hydropower firms is analyzed for the period between 2000 and 2013. A true random effects specification is estimated as a benchmark for the transient level of cost efficiency. The results show the presence of both transient as well as persistent cost inefficiencies. The GTREM predicts the aggregate level of cost inefficiency to amount to 21.8% (8.0% transient, 13.8% persistent) on average between 2000 and 2013. These two components differ in interpretation and implication. From an individual firm’s perspective, the two types of cost inefficiencies might require a firm’s management to respond with different improvement strategies. The existing level of persistent inefficiency could prevent the hydropower firms from adjusting their production processes to new market environments. From a regulatory point of view, the results of this study could be used in the scope and determination of the amount of financial support given to struggling firms.« less

The acceleration rate of cosmic rays at cosmic ray modified shocks

NASA Astrophysics Data System (ADS)

Saito, Tatsuhiko; Hoshino, Masahiro; Amano, Takanobu

It is a still controversial matter whether the production efficiency of cosmic rays (CRs) is relatively efficient or inefficient (e.g. Helder et al. 2009; Hughes et al. 2000; Fukui 2013). In upstream region of SNR shocks (the interstellar medium), the energy density of CRs is comparable to a substantial fraction of that of the thermal plasma (e.g. Ferriere 2001). In such a situation, CRs can possibly exert a back-reaction to the shocks and modify the global shock structure. These shocks are called cosmic ray modified shocks (CRMSs). In CRMSs, as a result of the nonlinear feedback, there are almost always up to three steady-state solutions for given upstream parameters, which are characterized by CR production efficiencies (efficient, intermediate and inefficient branch). We evaluate qualitatively the efficiency of the CR production in SNR shocks by considering the stability of CRMS, under the effects of i) magnetic fields and ii) injection, which play significant roles in efficiency of acceleration. By adopting two-fluid model (Drury & Voelk, 1981), we investigate the stability of CRMSs by means of time-dependent numerical simulations. As a result, we show explicitly the bi-stable feature of these multiple solutions, i.e., the efficient and inefficient branches are stable and the intermediate branch is unstable, and the intermediate branch transit to the inefficient one. This feature is independent of the effects of i) shock angles and ii) injection. Furthermore, we investigate the evolution from a hydrodynamic shock to CRMS in a self-consistent manner. From the results, we suggest qualitatively that the CR production efficiency at SNR shocks may be the least efficient.

Developing a strategy for improving efficiency in the heating sector in central and eastern Europe

DOE Office of Scientific and Technical Information (OSTI.GOV)

Meyer, A.S.

1995-12-31

Heating is a vital energy service in Central and Eastern Europe, but the current delivery mechanisms are riddled with problems. District heating (DH) in its present technical form and with the present management structures is an inefficient system which produces expensive heat. Customers cannot control it and react to overheating by opening windows, even in winter. DH facilities together with other forms of individual heating are responsible for air pollution, causing severe impacts on the health of urban residents. The issues relating to DH are discussed, the first World Bank activities and experiences with projects in Poland are analyzed, andmore » the cornerstones of a strategy to support future World Bank financing and the development of sound heating policies in CEE are presented.« less

Assessing inefficiency in euro bilateral exchange rates

NASA Astrophysics Data System (ADS)

Tabak, Benjamin M.; Cajueiro, Daniel O.

2006-07-01

This paper assesses inefficiency for 10 euro bilateral exchange rates. We study the dynamics of these time series by estimating Tsallis q entropic index and Hurst exponents using the local Whittle estimator. Empirical results suggest that US, Canadian and Singapore dollar are amongst the most efficient currencies, while Japanese yen and Swedish krona are amongst the most inefficient.

NREL Response to the Report 'Study of the Effects on Employment of Public Aid to Renewable Energy Sources' from King Juan Carlos University (Spain) (White Paper)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lantz, E.; Tegen, S.

2009-08-01

Job generation has been a part of the national dialogue surrounding energy policy and renewable energy (RE) for many years. RE advocates tout the ability of renewable energy to support new job opportunities in rural America and the manufacturing sector. Others argue that spending on renewable energy is an inefficient allocation of resources and can result in job losses in the broader economy. The report, Study of the Effects on Employment of Public Aid to Renewable Energy Sources, from King Juan Carlos University in Spain, is one recent addition to this debate. This report asserts that, on average, every renewablemore » energy job in Spain 'destroyed' 2.2 jobs in the broader Spanish economy. The authors also apply this ratio to the U.S. context to estimate expected job loss from renewable energy development and policy in the United States. This memo discusses fundamental and technical limitations of the analysis by King Juan Carlos University and notes critical assumptions implicit in the ultimate conclusions of their work. The memo also includes a review of traditional employment impact analyses that rely on accepted, peer-reviewed methodologies, and it highlights specific variables that can significantly influence the results of traditional employment impact analysis.« less

The Federated Satellite Systems paradigm: Concept and business case evaluation

NASA Astrophysics Data System (ADS)

Golkar, Alessandro; Lluch i Cruz, Ignasi

2015-06-01

This paper defines the paradigm of Federated Satellite Systems (FSS) as a novel distributed space systems architecture. FSS are networks of spacecraft trading previously inefficiently allocated and unused resources such as downlink bandwidth, storage, processing power, and instrument time. FSS holds the promise to enhance cost-effectiveness, performance and reliability of existing and future space missions, by networking different missions and effectively creating a pool of resources to exchange between participants in the federation. This paper introduces and describes the FSS paradigm, and develops an approach integrating mission analysis and economic assessments to evaluate the feasibility of the business case of FSS. The approach is demonstrated on a case study on opportunities enabled by FSS to enhance space exploration programs, with particular reference to the International Space Station. The application of the proposed methodology shows that the FSS concept is potentially able to create large commercial markets of in-space resources, by providing the technical platform to offer the opportunity for spacecraft to share or make use of unused resources within their orbital neighborhood. It is shown how the concept is beneficial to satellite operators, space agencies, and other stakeholders of the space industry to more flexibly interoperate space systems as a portfolio of assets, allowing unprecedented collaboration among heterogeneous types of missions.

Testing the hospital value proposition: an empirical analysis of efficiency and quality.

PubMed

Huerta, Timothy R; Ford, Eric W; Peterson, Lori T; Brigham, Keith H

2008-01-01

To assess the relationship between hospitals' X-inefficiency levels and overall care quality based on the National Quality Forum's 27 safe practices score and to improve the analytic strategy for assessing X-inefficiency. The 2005 versions of the American Hospital Association and Leapfrog Group's annual surveys were the basis of the study. Additional case mix indices and market variables were drawn from the Centers for Medicare and Medicaid Services data sources and the Area Resource File. Data envelopment analysis was used to determine hospitals' X-inefficiency scores relative to their market-level competitors. Regression was used to assess the relationship between X-inefficiency and quality, controlling for organizational and market characteristics. Expenses (total and labor expenditures), case-mix-adjusted admissions, length of stay, and licensed beds defined the X-inefficiency function. The overall National Quality Forum's safe practice score, health maintenance organization penetration, market share, and teaching status served as independent control variables in the regression. The National Quality Forum's safe practice scores are significantly and positively correlated to hospital X-inefficiency levels (beta = .105, p < or = .05). The analysis of the value proposition had very good explanatory power (adjusted R(2) = .414; p < or = .001; df = 7, 265). Contrary to earlier findings, health maintenance organization penetration and being a teaching hospital were positively related to X-inefficiency. Similar with others' findings, greater market share and for-profit ownership were negatively associated with X-inefficiency. Measurement of overall hospital quality is improving but can still be made better. Nevertheless, the National Quality Forum's measure is significantly related to efficiency and could be used to create differential pay-for-performance programs. A market-segmented analytic strategy for studying hospitals' efficiency yields results with a high degree of explanatory power.

Health resource allocation and productive efficiency of Chinese county hospitals: data from 1993 to 2005.

PubMed

Gai, Ruoyan Y; Zhou, Chengchao C; Xu, Lingzhong Z; Zhu, Min; Wang, Xingzhou Z; Li, Shixue X; Zheng, Wengui G; Song, Peipei P; Yang, Xuelai L; Fang, Liyi Y; Zhen, Yancheng C; Tang, Wei

2010-10-01

This study aims to assess trends in the productive efficiency of China's county hospitals during the economic transition using data from 1993 to 2005. A data envelopment analysis (DEA) framework was used to calculate the efficiency score of county hospitals in all 31 provinces. A C²R model and a BC² model were devised to respectively calculate overall and scale efficiency and pure technical efficiency at the hospital's current scale. Models included four inputs (number of medical staff; number of beds; value of fixed capital; and hospital expenditures) and three outputs (outpatient and emergency visits, number of inpatients, and hospital revenue) in total. As the results, geographical disparities in health resource allocation and county hospital productivity were noted. From 1993 to 2005, the number of county hospitals increased and their inputs, e.g. fixed capital in particular, grew rapidly. However, the amount of both outpatient and inpatient services declined somewhat especially in the middle and the western regions. The overall efficiency at the national level decreased slightly. County hospitals in the eastern region tended to have better overall, scale, and technical efficiency in comparison to the middle and the western regions. In conclusion, county hospitals are inefficient due to their enlarged scale and the reduced amount of health care services they provide. This issue should be addressed especially in the middle and the western regions, where health resources are far more limited and yet wasted. The effects of ongoing health sector reform on the productivity of county hospitals must be monitored and evaluated.

Periodic density modulation for quasi-phase-matching of optical frequency conversion is inefficient under shallow focusing and constant ambient pressure.

PubMed

Hadas, Itai; Bahabad, Alon

2016-09-01

The two main mechanisms of a periodic density modulation relevant to nonlinear optical conversion in a gas medium are spatial modulations of the index of refraction and of the number of emitters. For a one-dimensional model neglecting focusing and using a constant ambient pressure, it is shown theoretically and demonstrated numerically that the effects of these two mechanisms during frequency conversion cancel each other exactly. Under the considered conditions, this makes density modulation inefficient for quasi-phase-matching an optical frequency conversion process. This result is particularly relevant for high-order harmonic generation.

Dynamic Inefficiencies in an Employment-Based Health Insurance System: Theory and Evidence.

PubMed

Fang, Hanming; Gavazza, Alessandro

2011-12-01

We investigate the effects of the institutional settings of the US health care system on individuals' life-cycle medical expenditures. Health is a form of general human capital; labor turnover and labor-market frictions prevent an employer-employee pair from capturing the entire surplus from investment in an employee’s health. Thus, the pair underinvests in health during working years, thereby increasing medical expenditures during retirement. We provide empirical evidence consistent with the comparative statics predictions of our model using the Medical Expenditure Panel Survey (MEPS) and the Health and Retirement Study (HRS). Our estimates suggest significant inefficiencies in health investment in the United States.

Cost inefficiency in Washington hospitals: a stochastic frontier approach using panel data.

PubMed

Li, T; Rosenman, R

2001-06-01

We analyze a sample of Washington State hospitals with a stochastic frontier panel data model, specifying the cost function as a generalized Leontief function which, according to a Hausman test, performs better in this case than the translog form. A one-stage FGLS estimation procedure which directly models the inefficiency effects improves the efficiency of our estimates. We find that hospitals with higher casemix indices or more beds are less efficient while for-profit hospitals and those with higher proportion of Medicare patient days are more efficient. Relative to the most efficient hospital, the average hospital is only about 67% efficient.

Water Development, Allocation, and Institutions: A Role for Integrated Tools

NASA Astrophysics Data System (ADS)

Ward, F. A.

2008-12-01

Many parts of the world suffer from inadequate water infrastructure, inefficient water allocation, and weak water institutions. Each of these three challenges compounds the burdens imposed by inadequacies associated with the other two. Weak water infrastructure makes it hard to allocate water efficiently and undermines tracking of water rights and use, which blocks effective functioning of water institutions. Inefficient water allocation makes it harder to secure resources to develop new water infrastructure. Poorly developed water institutions undermine the security of water rights, which damages incentives to develop water infrastructure or use water efficiently. This paper reports on the development of a prototype basin scale economic optimization, in which existing water supplies are allocated more efficiently in the short run to provide resources for more efficient long-run water infrastructure development. Preliminary results provide the basis for designing water administrative proposals, building effective water infrastructure, increasing farm income, and meeting transboundary delivery commitments. The application is to the Kabul River Basin in Afghanistan, where food security has been compromised by a history of drought, war, damaged irrigation infrastructure, lack of reservoir storage, inefficient water allocation, and weak water institutions. Results illustrate increases in economic efficiency achievable when development programs simultaneously address interdependencies in water allocation, development, and institutions.

Optimising experimental design for MEG resting state functional connectivity measurement.

PubMed

Liuzzi, Lucrezia; Gascoyne, Lauren E; Tewarie, Prejaas K; Barratt, Eleanor L; Boto, Elena; Brookes, Matthew J

2017-07-15

The study of functional connectivity using magnetoencephalography (MEG) is an expanding area of neuroimaging, and adds an extra dimension to the more common assessments made using fMRI. The importance of such metrics is growing, with recent demonstrations of their utility in clinical research, however previous reports suggest that whilst group level resting state connectivity is robust, single session recordings lack repeatability. Such robustness is critical if MEG measures in individual subjects are to prove clinically valuable. In the present paper, we test how practical aspects of experimental design affect the intra-subject repeatability of MEG findings; specifically we assess the effect of co-registration method and data recording duration. We show that the use of a foam head-cast, which is known to improve co-registration accuracy, increased significantly the between session repeatability of both beamformer reconstruction and connectivity estimation. We also show that recording duration is a critical parameter, with large improvements in repeatability apparent when using ten minute, compared to five minute recordings. Further analyses suggest that the origin of this latter effect is not underpinned by technical aspects of source reconstruction, but rather by a genuine effect of brain state; short recordings are simply inefficient at capturing the canonical MEG network in a single subject. Our results provide important insights on experimental design and will prove valuable for future MEG connectivity studies. Copyright © 2016. Published by Elsevier Inc.

The quantile regression approach to efficiency measurement: insights from Monte Carlo simulations.

PubMed

Liu, Chunping; Laporte, Audrey; Ferguson, Brian S

2008-09-01

In the health economics literature there is an ongoing debate over approaches used to estimate the efficiency of health systems at various levels, from the level of the individual hospital - or nursing home - up to that of the health system as a whole. The two most widely used approaches to evaluating the efficiency with which various units deliver care are non-parametric data envelopment analysis (DEA) and parametric stochastic frontier analysis (SFA). Productivity researchers tend to have very strong preferences over which methodology to use for efficiency estimation. In this paper, we use Monte Carlo simulation to compare the performance of DEA and SFA in terms of their ability to accurately estimate efficiency. We also evaluate quantile regression as a potential alternative approach. A Cobb-Douglas production function, random error terms and a technical inefficiency term with different distributions are used to calculate the observed output. The results, based on these experiments, suggest that neither DEA nor SFA can be regarded as clearly dominant, and that, depending on the quantile estimated, the quantile regression approach may be a useful addition to the armamentarium of methods for estimating technical efficiency.

Combustion characteristics of Douglas Fir planer shavings. Technical progress report No. 4, September 16, 1977--September 15, 1978

DOE Office of Scientific and Technical Information (OSTI.GOV)

Junge, D.C.

1978-12-01

Significant quantities of wood residue fuels are presently being used in industrial steam generating facilities. Recent studies indicate that substantial additional quantities of wood residue fuels are available for energy generation in the form of steam and/or electricity. A limited data base on the combustion characteristics of wood residue fuels has resulted in the installation and operation of inefficient combustion systems for these fuels. This investigation of the combustion characteristics of wood residue fuels was undertaken to provide a data base which could be used to optimize the combustion of such fuels. Optimization of the the combustion process in industrialmore » boilers serves to improve combustion efficiency and to reduce air pollutant emissions generated in the combustion process. This report presents data on the combustion characteristics of Douglas Fir planer shavings. The data were obtained in a pilot scale combustion test facility at Oregon State Univerisity. Other technical reports present data on the combustion characteristics of: Douglas Fir bark, Red Alder sawdust, Red Alder bark, Ponderosa pine bark, Hemlock bark, and Eastern White Pine bark. An executive summary report is also available which compares the combustion characteristics of the various fuel species.« less

Research on Automatic Positioning System of Ultrasonic Testing of Wind Turbine Blade Flaws

NASA Astrophysics Data System (ADS)

Liu, Q. X.; Wang, Z. H.; Long, S. G.; Cai, M.; Cai, M.; Wang, X.; Chen, X. Y.; Bu, J. L.

2017-11-01

Ultrasonic testing technology has been used essentially in non-destructive testing of wind turbine blades. However, it is fact that the ultrasonic flaw detection method has inefficiently employed in recent years. This is because the testing result will illustrate a small deviation due to the artificial, environmental and technical factors. Therefore, it is an urgent technical demand for engineers to test the various flaws efficiently and quickly. An automatic positioning system has been designed in this paper to record the moving coordinates and the target distance in real time. Simultaneously, it could launch and acquire the sonic wave automatically. The ADNS-3080 optoelectronic chip is manufactured by Agilent Technologies Inc, which is also utilized in the system. With the combination of the chip, the power conversion module and the USB transmission module, the collected data can be transmitted from the upper monitor to the hardware that could process and control the data through software programming. An experiment has been designed to prove the reliability of automotive positioning system. The result has been validated by comparing the result collected form LABVIEW and actual plots on Perspex plane, it concludes that the system possesses high accuracy and magnificent meanings in practical engineering.

Medical Expenses Matter Most for the Poor: Evidence from a Vietnamese Medical Survey.

PubMed

Vuong, Quan Hoang

2016-12-01

Less developed countries, Vietnam included, face serious challenges of inefficient diagnosis, inaccessibility to healthcare facilities, and high medical expenses. Information on medical costs, technical and professional capabilities of healthcare providers and service deliveries becomes influential when it comes to patients' decision on choices of healthcare providers. The study employs a data set containing 1,459 observations collected from a survey on Vietnamese patients in late 2015. The standard categorical data analysis is performed to provide statistical results, yielding insights from the empirical data. Patients' socioeconomic status (SES) is found to be associated with the degree of significance of key factors (i.e., medical costs, professional capabilities and service deliveries), but medical expenses are the single most important factor that influence a decision by the poor, 2.28 times as critical as the non-poor. In contrary, the non-poor tend to value technical capabilities and services more, with odds ratios being 1.54 and 1.32, respectively. There exists a risk for the poor in decision making based on medical expenses solely. The solution may rest with: a) improved health insurance mechanism; and, b) obtaining additional revenues from value-added services, which can help defray the poor's financial burdens.

Voluntary Medical Male Circumcision Scale-Up in Nyanza, Kenya: Evaluating Technical Efficiency and Productivity of Service Delivery

PubMed Central

Omondi Aduda, Dickens S.; Ouma, Collins; Onyango, Rosebella; Onyango, Mathews; Bertrand, Jane

2015-01-01

Background Voluntary medical male circumcision (VMMC) service delivery is complex and resource-intensive. In Kenya’s context there is still paucity of information on resource use vis-à-vis outputs as programs scale up. Knowledge of technical efficiency, productivity and potential sources of constraints is desirable to improve decision-making. Objective To evaluate technical efficiency and productivity of VMMC service delivery in Nyanza in 2011/2012 using data envelopment analysis. Design Comparative process evaluation of facilities providing VMMC in Nyanza in 2011/2012 using output orientated data envelopment analysis. Results Twenty one facilities were evaluated. Only 1 of 7 variables considered (total elapsed operation time) significantly improved from 32.8 minutes (SD 8.8) in 2011 to 30 minutes (SD 6.6) in 2012 (95%CI = 0.0350–5.2488; p = 0.047). Mean scale technical efficiency significantly improved from 91% (SD 19.8) in 2011 to 99% (SD 4.0) in 2012 particularly among outreach compared to fixed service delivery facilities (CI -31.47959–4.698508; p = 0.005). Increase in mean VRS technical efficiency from 84% (SD 25.3) in 2011 and 89% (SD 25.1) in 2012 was not statistically significant. Benchmark facilities were #119 and #125 in 2011 and #103 in 2012. Malmquist Productivity Index (MPI) at fixed facilities declined by 2.5% but gained by 4.9% at outreach ones by 2012. Total factor productivity improved by 83% (p = 0.032) in 2012, largely due to progress in technological efficiency by 79% (p = 0.008). Conclusions Significant improvement in scale technical efficiency among outreach facilities in 2012 was attributable to accelerated activities. However, ongoing pure technical inefficiency requires concerted attention. Technological progress was the key driver of service productivity growth in Nyanza. Incorporating service-quality dimensions and using stepwise-multiple criteria in performance evaluation enhances comprehensiveness and validity. These findings highlight site-level resource use and sources of variations in VMMC service productivity, which are important for program planning. PMID:25706119

Estimating and Testing Mediation Effects with Censored Data

ERIC Educational Resources Information Center

Wang, Lijuan; Zhang, Zhiyong

2011-01-01

This study investigated influences of censored data on mediation analysis. Mediation effect estimates can be biased and inefficient with censoring on any one of the input, mediation, and output variables. A Bayesian Tobit approach was introduced to estimate and test mediation effects with censored data. Simulation results showed that the Bayesian…

Identifying Inefficient Single-Family Homes With Utility Bill Analysis: Preprint

DOE Office of Scientific and Technical Information (OSTI.GOV)

Casey, S.; Krarti, M.; Bianchi, M.

2010-08-01

Differentiating between energy-efficient and inefficient single-family homes on a community scale helps identify and prioritize candidates for energy-efficiency upgrades. Prescreening diagnostic procedures can further retrofit efforts by providing efficiency information before a site-visit is conducted. We applied the prescreening diagnostic to a simulated community of homes in Boulder, Colorado and analyzed energy consumption data to identify energy-inefficient homes.

Ideas To Save Electricity

ERIC Educational Resources Information Center

Gardner, John C.

1974-01-01

Significant energy savings can be effected through stopping obvious waste of water, electricity, and heat; purchasing equipment with the correct voltage and horsepower; equipment maintenance; and redesigning or replacing obsolete or inefficient equipment. (Author/MF)

Inefficient star formation in extremely metal poor galaxies.

PubMed

Shi, Yong; Armus, Lee; Helou, George; Stierwalt, Sabrina; Gao, Yu; Wang, Junzhi; Zhang, Zhi-Yu; Gu, Qiusheng

2014-10-16

The first galaxies contain stars born out of gas with few or no 'metals' (that is, elements heavier than helium). The lack of metals is expected to inhibit efficient gas cooling and star formation, but this effect has yet to be observed in galaxies with an oxygen abundance (relative to hydrogen) below a tenth of that of the Sun. Extremely metal poor nearby galaxies may be our best local laboratories for studying in detail the conditions that prevailed in low metallicity galaxies at early epochs. Carbon monoxide emission is unreliable as a tracer of gas at low metallicities, and while dust has been used to trace gas in low-metallicity galaxies, low spatial resolution in the far-infrared has typically led to large uncertainties. Here we report spatially resolved infrared observations of two galaxies with oxygen abundances below ten per cent of the solar value, and show that stars formed very inefficiently in seven star-forming clumps in these galaxies. The efficiencies are less than a tenth of those found in normal, metal rich galaxies today, suggesting that star formation may have been very inefficient in the early Universe.

Is the hospital decision to seek accreditation an effective one?

PubMed

Grepperud, Sverre

2015-01-01

The rapid expansion in the number of accredited hospitals justifies inquiry into the motives of hospitals in seeking accreditation and its social effectiveness. This paper presents a simple decision-theoretic framework where cost reductions and improved quality of care represent the endpoint benefits from accreditation. We argue that hospital accreditation, although acting as a market-signaling device, might be a socially inefficient institution. First, there is at present no convincing evidence for accreditation causing output quality improvements. Second, hospitals could seek accreditation, even though doing so is socially inefficient, because of moral hazard, consumer misperceptions, and nonprofit motivations. Finally, hospitals that seek accreditation need not themselves believe in output quality improvements from accreditation. Consequently, while awaiting additional evidence on accreditation, policy makers and third-party payers should exercise caution in encouraging such programs. Copyright © 2014 John Wiley & Sons, Ltd.

Ergonomics content in the physical education teacher's guide in Rwanda.

PubMed

Nellutla, Manobhiram; Patel, Hetal; Kabanda, Aline; Nuhu, Assuman

2012-01-01

An important aspect that affects the effectiveness of ergonomic programs is that inefficient mechanical functioning start at an early age and that back pain and posture problems are already evident in children. Children, from a very early age, as well as adults spend an ever increasing amount of their time in front of computer and television screens. The cumulative effect of this sedentary lifestyle leads to improper posture, as well as inefficient and harmful movement patterns and loss of basic physical skills. Physical Education course should deal not only with sports and physical activities, but also with broader aspects of life-skills and physical functionality. It should offer a solution to the modern technology-based society. Keeping this in perspective, Ergonomics content was introduced in Physical Education Teacher's Guide in Rwandan schools with an aim in preventing musculoskeletal disorder in children.

Potential gains from hospital mergers in Denmark.

PubMed

Kristensen, Troels; Bogetoft, Peter; Pedersen, Kjeld Moeller

2010-12-01

The Danish hospital sector faces a major rebuilding program to centralize activity in fewer and larger hospitals. We aim to conduct an efficiency analysis of hospitals and to estimate the potential cost savings from the planned hospital mergers. We use Data Envelopment Analysis (DEA) to estimate a cost frontier. Based on this analysis, we calculate an efficiency score for each hospital and estimate the potential gains from the proposed mergers by comparing individual efficiencies with the efficiency of the combined hospitals. Furthermore, we apply a decomposition algorithm to split merger gains into technical efficiency, size (scale) and harmony (mix) gains. The motivation for this decomposition is that some of the apparent merger gains may actually be available with less than a full-scale merger, e.g., by sharing best practices and reallocating certain resources and tasks. Our results suggest that many hospitals are technically inefficient, and the expected "best practice" hospitals are quite efficient. Also, some mergers do not seem to lower costs. This finding indicates that some merged hospitals become too large and therefore experience diseconomies of scale. Other mergers lead to considerable cost reductions; we find potential gains resulting from learning better practices and the exploitation of economies of scope. To ensure robustness, we conduct a sensitivity analysis using two alternative returns-to-scale assumptions and two alternative estimation approaches. We consistently find potential gains from improving the technical efficiency and the exploitation of economies of scope from mergers.

Protein detection through different platforms of immuno-loop-mediated isothermal amplification

NASA Astrophysics Data System (ADS)

Pourhassan-Moghaddam, Mohammad; Rahmati-Yamchi, Mohammad; Akbarzadeh, Abolfazl; Daraee, Hadis; Nejati-Koshki, Kazem; Hanifehpour, Younes; Joo, Sang Woo

2013-11-01

Different immunoassay-based methods have been devised to detect protein targets. These methods have some challenges that make them inefficient for assaying ultra-low-amounted proteins. ELISA, iPCR, iRCA, and iNASBA are the common immunoassay-based methods of protein detection, each of which has specific and common technical challenges making it necessary to introduce a novel method in order to avoid their problems for detection of target proteins. Here we propose a new method nominated as `immuno-loop-mediated isothermal amplification' or `iLAMP'. This new method is free from the problems of the previous methods and has significant advantages over them. In this paper we also offer various configurations in order to improve the applicability of this method in real-world sample analyses. Important potential applications of this method are stated as well.

Generalized Hurst exponent approach to efficiency in MENA markets

NASA Astrophysics Data System (ADS)

Sensoy, A.

2013-10-01

We study the time-varying efficiency of 15 Middle East and North African (MENA) stock markets by generalized Hurst exponent analysis of daily data with a rolling window technique. The study covers a time period of six years from January 2007 to December 2012. The results reveal that all MENA stock markets exhibit different degrees of long-range dependence varying over time and that the Arab Spring has had a negative effect on market efficiency in the region. The least inefficient market is found to be Turkey, followed by Israel, while the most inefficient markets are Iran, Tunisia, and UAE. Turkey and Israel show characteristics of developed financial markets. Reasons and implications are discussed.

When Cooperation Was Efficient or Inefficient. Functional Near-Infrared Spectroscopy Evidence

PubMed Central

Balconi, Michela; Vanutelli, Maria E.

2017-01-01

Cooperation is a construct within social cognition that requires both self-perception and the comprehension of others' actions. In the case of synchronized activities the adoption of common strategies is crucial, but this process can be strongly influenced by those variables. In fact, self-perceived efficacy within the social exchange can affect the motivational components toward the creation of synergic actions. Thus, what happens when our performance is efficient or inefficient during cooperation? This question was answered in the present study where we compared behavioral performance and neural activation across different conditions where subjects received an external feedback assessing a good or a poor outcome during a cooperative game. The request was to synchronize responses in a way to achieve good cooperation scorings. Results showed that the behavioral performance was affected by feedback valence, since the negative feedback induced a significant worse performance in contrast to the positive one, which significantly increased performance. For what concerns neural activation, data from functional near-infrared spectroscopy (fNIRS) showed a specific lateralization effect with the right DLPFC recruited in the case of negative feedback, and an opposite left-sided effect in the case of a positive feedback. Findings were interpreted by proposing that the inefficient condition could be similar to a competitive context since the perception of a failed joint action could have frustrated the cooperative attitude and the use of joint strategies. PMID:28536508

What Makes CLIL Leadership Effective? A Case Study

ERIC Educational Resources Information Center

Soler, David; González-Davies, Maria; Iñesta, Anna

2017-01-01

The swift growth of Content and Language Integrated Learning (CLIL) has caused a diversification of CLIL models designed to fit specific contexts. Although variation across programmes is inevitable, exploring the main factors for the effective implementation of CLIL may help avoid the risk of promoting inefficient practices. The main purpose of…

Evaluation of the effect of gate strategies in drayage related emissions.

DOT National Transportation Integrated Search

2013-03-01

Intermodal Marine Container Terminals are experiencing growth in container volumes and are under pressure to : develop strategies to accommodate increasing demand. One of the major factors contributing to the problem is : inefficient gate operations ...

Trends in hospital efficiency among metropolitan markets.

PubMed

Wang, B B; Ozcan, Y A; Wan, T T; Harrison, J

1999-04-01

This study evaluates trends in efficiency among American hospital markets. A total of 6010 hospitals were identified for use in the analysis from the American Hospital Association's Annual Surveys for 1989 and 1993. Using data envelopment analysis (DEA), a longitudinal study of hospital efficiency was conducted on all 314 metropolitan markets in the United States. Results suggest that large hospital markets generally demonstrated higher inefficiency. The major inefficiencies exist in the availability of hospital services, the number of operating beds, the utilization of hospital staffing and operating expenses. Consequently, the large hospital market had a significant excess of health manpower that resulted in inefficiency that amounted to approximately $23 billion. From a policy perspective, this study has shed some light on the need to establish more specific policies to address inefficiency in the health care industry.

Effects of aging and divided attention on memory for items and their contexts.

PubMed

Craik, Fergus I M; Luo, Lin; Sakuta, Yuiko

2010-12-01

It is commonly found that memory for context declines disproportionately with aging, arguably due to a general age-related deficit in associative memory processes. One possible mechanism for such deficits is an age-related reduction in available processing resources. In two experiments we compared the effects of aging to the effects of division of attention in younger adults on memory for items and context. Using a technique proposed by Craik (1989), linear functions relating memory performance for items and their contexts were derived for a Young Full Attention group, a Young Divided Attention group, and an Older Adult group. Results suggested that the Old group showed an additional deficit in associative memory that was not mimicked by divided attention. It is speculated that both divided attention and aging are associated with a loss of available processing resources that may reflect inefficient frontal lobe functioning, whereas the additional age-related decrement in associative memory may reflect inefficient processing in medial-temporal regions. (c) 2010 APA, all rights reserved).

Human Factors in Training - Space Flight Resource Management Training

NASA Technical Reports Server (NTRS)

Bryne, Vicky; Connell, Erin; Barshi, Immanuel; Arsintescu, L.

2009-01-01

Accidents and incidents show that high workload-induced stress and poor teamwork skills lead to performance decrements and errors. Research on teamwork shows that effective teams are able to adapt to stressful situations, and to reduce workload by using successful strategies for communication and decision making, and through dynamic redistribution of tasks among team members. Furthermore, superior teams are able to recognize signs and symptoms of workload-induced stress early, and to adapt their coordination and communication strategies to the high workload, or stress conditions. Mission Control Center (MCC) teams often face demanding situations in which they must operate as an effective team to solve problems with crew and vehicle during onorbit operations. To be successful as a team, flight controllers (FCers) must learn effective teamwork strategies. Such strategies are the focus of Space Flight Resource Management (SFRM) training. SFRM training in MOD has been structured to include some classroom presentations of basic concepts and case studies, with the assumption that skill development happens in mission simulation. Integrated mission simulations do provide excellent opportunities for FCers to practice teamwork, but also require extensive technical knowledge of vehicle systems, mission operations, and crew actions. Such technical knowledge requires lengthy training. When SFRM training is relegated to integrated simulations, FCers can only practice SFRM after they have already mastered the technical knowledge necessary for these simulations. Given the centrality of teamwork to the success of MCC, holding SFRM training till late in the flow is inefficient. But to be able to train SFRM earlier in the flow, the training cannot rely on extensive mission-specific technical knowledge. Hence, the need for a generic SFRM training framework that would allow FCers to develop basic teamwork skills which are mission relevant, but without the required mission knowledge. Work on SFRM training has been conducted in collaboration with the Expedition Vehicle Division at the Mission Operations Directorate (MOD) and with United Space Alliance (USA) which provides training to Flight Controllers. The space flight resource management training work is part of the Human Factors in Training Directed Research Project (DRP) of the Space Human Factors Engineering (SHFE) Project under the Space Human Factors and Habitability (SHFH) Element of the Human Research Program (HRP). Human factors researchers at the Ames Research Center have been investigating team work and distributed decision making processes to develop a generic SFRM training framework for flight controllers. The work proposed for FY10 continues to build on this strong collaboration with MOD and the USA Training Group as well as previous research in relevant domains such as aviation. In FY10, the work focuses on documenting and analyzing problem solving strategies and decision making processes used in MCC by experienced FCers.

The Defense Acquisitions System Through the Eyes of a Marine Corps Project Officer: Observations, Inefficiencies, and Proposed Solutions

DTIC Science & Technology

2013-04-03

adequate return on investments . As part of a results-oriented culture, acquisitions leaders must identify and hold accountable those employees who are...accountability and leadership is at the heart of acquisitions inefficiency. Employees that lack a sense of urgency and that are not fully invested in...inefficiency. Employees that lack a sense of urgency and that are not fully invested in delivering a quality product to the user, in a timely manner, are

Wrist electrogoniometry: are current mathematical correction procedures effective in reducing crosstalk in functional assessment?

PubMed

Foltran, Fabiana A; Silva, Luciana C C B; Sato, Tatiana O; Coury, Helenice J C G

2013-01-01

The recording of human movement is an essential requirement for biomechanical, clinical, and occupational analysis, allowing assessment of postural variation, occupational risks, and preventive programs in physical therapy and rehabilitation. The flexible electrogoniometer (EGM), considered a reliable and accurate device, is used for dynamic recordings of different joints. Despite these advantages, the EGM is susceptible to measurement errors, known as crosstalk. There are two known types of crosstalk: crosstalk due to sensor rotation and inherent crosstalk. Correction procedures have been proposed to correct these errors; however no study has used both procedures in clinical measures for wrist movements with the aim to optimize the correction. To evaluate the effects of mathematical correction procedures on: 1) crosstalk due to forearm rotation, 2) inherent sensor crosstalk; and 3) the combination of these two procedures. 43 healthy subjects had their maximum range of motion of wrist flexion/extension and ulnar/radials deviation recorded by EGM. The results were analyzed descriptively, and procedures were compared by differences. There was no significant difference in measurements before and after the application of correction procedures (P<0.05). Furthermore, the differences between the correction procedures were less than 5° in most cases, having little impact on the measurements. Considering the time-consuming data analysis, the specific technical knowledge involved, and the inefficient results, the correction procedures are not recommended for wrist recordings by EGM.

Effect of red cyst cell inoculation and iron(II) supplementation on autotrophic astaxanthin production by Haematococcus pluvialis under outdoor summer conditions.

PubMed

Hong, Min-Eui; Choi, Yoon Young; Sim, Sang Jun

2016-01-20

The negative effect of heat stress on the autotrophic astaxanthin production by Haematococcus pluvialis has been observed during outdoor culture in summer. Under the summer conditions, the proliferation of vegetative cells was highly halted in the green stage and the inducibility in the biosynthesis of astaxanthin was partly hindered in the red stage. Herein, under outdoor summer conditions in which variations of the diurnal temperature occur, heat-stress-driven inefficient vegetative growth of H. pluvialis was highly improved by inoculating the red cyst cells; thereby, maintaining relatively moderate intracellular carotenoid levels in the green stage. Subsequently, a remarkably enhanced astaxanthin titer was successfully obtained by supplementing 50 μM iron(II) to induce the heat stress-driven Haber-Weiss reaction in the red stage. As a result, the productivity of astaxanthin in the cells cultured under summer temperature conditions (23.4-33.5 °C) using the two methods of red cell (cyst) inoculation and the iron(Fe(2+)) supplementation was increased by 147% up to 5.53 mg/L day compared with that of the cells cultured under spring temperature conditions (17.5-27.3 °C). Our technical solutions will definitely improve the annual natural astaxanthin productivity in H. pluvialis in locations confronted by hot summer weather, particularly in large-scale closed photobioreactor systems. Copyright © 2015 Elsevier B.V. All rights reserved.

Developmental trends in utilizing perceptual closure for grouping of shape: effects of spatial proximity and collinearity.

PubMed

Hadad, Bat-Sheva; Kimchi, Ruth

2006-11-01

In two experiments, visual search was used to study the grouping of shape on the basis of perceptual closure among participants 5-23 years of age. We first showed that young children, like adults, demonstrate an efficient search for a concave target among convex distractors for closed connected stimuli but an inefficient search for open stimuli. Reliable developmental differences, however, were observed in search for fragmented stimuli as a function of spatial proximity and collinearity between the closure-inducing fragments. When only closure was available, search for all the age groups was equally efficient for spatially close fragments and equally inefficient for spatially distant fragments. When closure and collinearity were available, search for spatially close fragments was equally efficient for all the age groups, but search for spatially distant fragments was inefficient for younger children and improved significantly between ages 5 and 10. These findings suggest that young children can utilize closure as efficiently as can adults for the grouping of shape for closed or nearly closed stimuli. When the closure-inducing fragments are spatially distant, only older children and adults, but not 5-year-olds, can utilize collinearity to enhance closure for the perceptual grouping of shape.

Functional but Inefficient Kinesthetic Motor Imagery in Adolescents with Autism Spectrum Disorder.

PubMed

Chen, Ya-Ting; Tsou, Kuo-Su; Chen, Hao-Ling; Wong, Ching-Ching; Fan, Yang-Teng; Wu, Chien-Te

2018-03-01

Whether action representation in individuals with autism spectrum disorder (ASD) is deficient remains controversial, as previous studies of action observation or imitation report conflicting results. Here we investigated the characteristics of action representation in adolescents with ASD through motor imagery (MI) using a hand rotation and an object rotation task. Comparable with the typically-developing group, the individuals with ASD were able to spontaneously use kinesthetic MI to perform the hand rotation task, as manifested by the significant biomechanical effects. However, the ASD group performed significantly slower only in the hand rotation task, but not in the object rotation task. The findings suggest that the adolescents with ASD showed inefficient but functional kinesthetic MI, implicating that their action representation might be preserved.

Identifying best practices for snowplow route optimization : final report.

DOT National Transportation Integrated Search

2016-12-01

Well-designed winter maintenance routes result in snow and ice control service that is both more effective, because roads are cleared more rapidly, and more cost-efficient, because deadheading, route overlap and other inefficiencies are reduced or el...

Efficiency of private and public primary health facilities accredited by the National Health Insurance Authority in Ghana.

PubMed

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Akazili, James; Spieker, Nicole; Arhinful, Daniel Kojo; Rinke de Wit, Tobias F

2015-01-01

Despite improvements in a number of health outcome indicators partly due to the National Health Insurance Scheme (NHIS), Ghana is unlikely to attain all its health-related millennium development goals before the end of 2015. Inefficient use of available limited resources has been cited as a contributory factor for this predicament. This study sought to explore efficiency levels of NHIS-accredited private and public health facilities; ascertain factors that account for differences in efficiency and determine the association between quality care and efficiency levels. The study is a cross-sectional survey of NHIS-accredited primary health facilities (n = 64) in two regions in southern Ghana. Data Envelopment Analysis was used to estimate technical efficiency of sampled health facilities while Tobit regression was employed to predict factors associated with efficiency levels. Spearman correlation test was performed to determine the association between quality care and efficiency. Overall, 20 out of the 64 health facilities (31 %) were optimally efficient relative to their peers. Out of the 20 efficient facilities, 10 (50 %) were Public/government owned facilities; 8 (40 %) were Private-for-profit facilities and 2 (10 %) were Private-not-for-profit/Mission facilities. Mission (Coef. = 52.1; p = 0.000) and Public (Coef. = 42.9; p = 0.002) facilities located in the Western region (predominantly rural) had higher odds of attaining the 100 % technical efficiency benchmark than those located in the Greater Accra region (largely urban). No significant association was found between technical efficiency scores of health facilities and many technical quality care proxies, except in overall quality score per the NHIS accreditation data (Coef. = -0.3158; p < 0.05) and SafeCare Essentials quality score on environmental safety for staff and patients (Coef. = -0.2764; p < 0.05) where the association was negative. The findings suggest some level of wastage of health resources in many healthcare facilities, especially those located in urban areas. The Ministry of Health and relevant stakeholders should undertake more effective need analysis to inform resource allocation, distribution and capacity building to promote efficient utilization of limited resources without compromising quality care standards.

Optimal planning for the sustainable utilization of municipal solid waste.

PubMed

Santibañez-Aguilar, José Ezequiel; Ponce-Ortega, José María; Betzabe González-Campos, J; Serna-González, Medardo; El-Halwagi, Mahmoud M

2013-12-01

The increasing generation of municipal solid waste (MSW) is a major problem particularly for large urban areas with insufficient landfill capacities and inefficient waste management systems. Several options associated to the supply chain for implementing a MSW management system are available, however to determine the optimal solution several technical, economic, environmental and social aspects must be considered. Therefore, this paper proposes a mathematical programming model for the optimal planning of the supply chain associated to the MSW management system to maximize the economic benefit while accounting for technical and environmental issues. The optimization model simultaneously selects the processing technologies and their location, the distribution of wastes from cities as well as the distribution of products to markets. The problem was formulated as a multi-objective mixed-integer linear programing problem to maximize the profit of the supply chain and the amount of recycled wastes, where the results are showed through Pareto curves that tradeoff economic and environmental aspects. The proposed approach is applied to a case study for the west-central part of Mexico to consider the integration of MSW from several cities to yield useful products. The results show that an integrated utilization of MSW can provide economic, environmental and social benefits. Copyright © 2013 Elsevier Ltd. All rights reserved.

Modelling the Effects of Teacher Demand Factors on Teacher Understaffing in Public Secondary Schools in Kenya

ERIC Educational Resources Information Center

Wamukuru, David Kuria

2016-01-01

The secondary school teacher labour market faces many challenges including, escalating teacher wage bill, teacher shortages that occur alongside teacher surpluses, inadequate teacher distribution and inefficient teacher utilization. There is the need therefore to understand the effects of the factors determining demand for secondary school…

Production and efficiency of large wildland fire suppression effort: A stochastic frontier analysis

Treesearch

Hari Katuwal; Dave Calkin; Michael S. Hand

2016-01-01

This study examines the production and efficiency of wildland fire suppression effort. We estimate the effectiveness of suppression resource inputs to produce controlled fire lines that contain large wildland fires using stochastic frontier analysis. Determinants of inefficiency are identified and the effects of these determinants on the daily production of...

Quantifying ataxia: ideal trajectory analysis--a technical note

NASA Technical Reports Server (NTRS)

McPartland, M. D.; Krebs, D. E.; Wall, C. 3rd

2000-01-01

We describe a quantitative method to assess repeated stair stepping stability. In both the mediolateral (ML) and anterioposterior (AP) directions, the trajectory of the subject's center of mass (COM) was compared to an ideal sinusoid. The two identified sinusoids were unique in each direction but coupled. Two dimensionless numbers-the mediolateral instability index (IML) and AP instability index (IAP)-were calculated using the COM trajectory and ideal sinusoids for each subject with larger index values resulting from less stable performance. The COM trajectories of nine nonimpaired controls and six patients diagnosed with unilateral or bilateral vestibular labyrinth hypofunction were analyzed. The average IML and IAP values of labyrinth disorder patients were respectively 127% and 119% greater than those of controls (p<0.014 and 0.006, respectively), indicating that the ideal trajectory analysis distinguishes persons with labyrinth disorder from those without. The COM trajectories also identify movement inefficiencies attributable to vestibulopathy.

Combustion characteristics of eastern white pine bark and Douglas fir planer shavings. Technical Progress Report No. 5, September 16, 1977--September 15, 1978

DOE Office of Scientific and Technical Information (OSTI.GOV)

Junge, D.C.

1978-12-01

Significant quantities of wood residue fuels are presently being used in industrial steam generating facilities. Recent studies indicate that substantial additional quantities of wood residue fuels are available for energy generation in the form of steam and/or electricity. A limited data base on the combustion characteristics of wood residue fuels has resulted in the installation and operation of inefficient combustion systems for these fuels. This investigation of the combustion characteristics of wood residue fuels was undertaken to provide a data base which could be used to optimize the combustion of such fuels. Optimization of the combustion process in industrial boilersmore » serves to improve combustion efficiency and to reduce air pollutant emissions generated in the combustion process. Data are presented on the combustion characteristics of eastern white pine bark mixed with Douglas fir planer shavings.« less

[Primary care: decentralization and efficiency].

PubMed

Pinillos, M; Antoñanzas, F

2002-01-01

The purpose of this study was to evaluate whether the productive behavior of health centers in autonomous communities with competence in health is more efficient than that among centers belonging to Spanish public health system (INSALUD). The technical efficiency of 66 health centers in Alava, Navarre and La Rioja was analyzed. Centers in autonomous communities that in 1997 had been granted complete authority from the central government to manage their healthcare services were compared with centers whose administration, in the same year, was still in the hands of INSALUD. The method used to measure and quantify the efficiency of these centers was data envelopment analysis. Nonparametric contrast of the health centers' mean efficiency rates revealed no significant differences in the (in)efficiency of centers from La Rioja, Navarre and Alava. The results obtained from the model of efficiency measurement used did not indicate that decentralization improves the productive efficiency of primary care centers.

Interpreting MAD within multiple accretion regimes

NASA Astrophysics Data System (ADS)

Mocz, Philip; Guo, Xinyi

2015-02-01

General relativistic magnetohydrodynamic (GRMHD) simulations of accreting black holes in the radiatively inefficient regime show that systems with sufficient magnetic poloidal flux become magnetically arrested disc (MAD) systems, with a well-defined relationship between the magnetic flux and the mass accretion rate. Recently, Zamaninasab et al. report that the jet magnetic flux and accretion disc luminosity are tightly correlated over 7 orders of magnitude for a sample of 76 radio-loud active galaxies, concluding that the data are explained by the MAD mode of accretion. Their analysis assumes radiatively efficient accretion, and their sample consists primarily of radiatively efficient sources, while GRMHD simulations of MAD thus far have been carried out in the radiatively inefficient regime. We propose a model to interpret MAD systems in the context of multiple accretion regimes, and apply it to the sample in Zamaninasab et al., along with additional radiatively inefficient sources from archival data. We show that most of the radiatively inefficient radio-loud galaxies are consistent with being MAD systems. Assuming the MAD relationship found in radiatively inefficient simulations holds at other accretion regimes, a significant fraction of our sample can be candidates for MAD systems. Future GRMHD simulations have yet to verify the validity of this assumption.

Relationships of efficiency to reproductive disorders in Danish milk production: a stochastic frontier analysis.

PubMed

Lawson, L G; Bruun, J; Coelli, T; Agger, J F; Lund, M

2004-01-01

Relationships of various reproductive disorders and milk production performance of Danish dairy farms were investigated. A stochastic frontier production function was estimated using data collected in 1998 from 514 Danish dairy farms. Measures of farm-level milk production efficiency relative to this production frontier were obtained, and relationships between milk production efficiency and the incidence risk of reproductive disorders were examined. There were moderate positive relationships between milk production efficiency and retained placenta, induction of estrus, uterine infections, ovarian cysts, and induction of birth. Inclusion of reproductive management variables showed that these moderate relationships disappeared, but directions of coefficients for almost all those variables remained the same. Dystocia showed a weak negative correlation with milk production efficiency. Farms that were mainly managed by young farmers had the highest average efficiency scores. The estimated milk losses due to inefficiency averaged 1142, 488, and 256 kg of energy-corrected milk per cow, respectively, for low-, medium-, and high-efficiency herds. It is concluded that the availability of younger cows, which enabled farmers to replace cows with reproductive disorders, contributed to high cow productivity in efficient farms. Thus, a high replacement rate more than compensates for the possible negative effect of reproductive disorders. The use of frontier production and efficiency/inefficiency functions to analyze herd data may enable dairy advisors to identify inefficient herds and to simulate the effect of alternative management procedures on the individual herd's efficiency.

ADHD performance reflects inefficient but not impulsive information processing: a diffusion model analysis.

PubMed

Metin, Baris; Roeyers, Herbert; Wiersema, Jan R; van der Meere, Jaap J; Thompson, Margaret; Sonuga-Barke, Edmund

2013-03-01

Attention-deficit/hyperactivity disorder (ADHD) is associated with performance deficits across a broad range of tasks. Although individual tasks are designed to tap specific cognitive functions (e.g., memory, inhibition, planning, etc.), these deficits could also reflect general effects related to either inefficient or impulsive information processing or both. These two components cannot be isolated from each other on the basis of classical analysis in which mean reaction time (RT) and mean accuracy are handled separately. Seventy children with a diagnosis of combined type ADHD and 50 healthy controls (between 6 and 17 years) performed two tasks: a simple two-choice RT (2-CRT) task and a conflict control task (CCT) that required higher levels of executive control. RT and errors were analyzed using the Ratcliff diffusion model, which divides decisional time into separate estimates of information processing efficiency (called "drift rate") and speed-accuracy tradeoff (SATO, called "boundary"). The model also provides an estimate of general nondecisional time. Results were the same for both tasks independent of executive load. ADHD was associated with lower drift rate and less nondecisional time. The groups did not differ in terms of boundary parameter estimates. RT and accuracy performance in ADHD appears to reflect inefficient rather than impulsive information processing, an effect independent of executive function load. The results are consistent with models in which basic information processing deficits make an important contribution to the ADHD cognitive phenotype. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Allocentric but not egocentric visual memory difficulties in adults with ADHD may represent cognitive inefficiency.

PubMed

Brown, Franklin C; Roth, Robert M; Katz, Lynda J

2015-08-30

Attention Deficit Hyperactivity Disorder (ADHD) has often been conceptualized as arising executive dysfunctions (e.g., inattention, defective inhibition). However, recent studies suggested that cognitive inefficiency may underlie many ADHD symptoms, according to reaction time and processing speed abnormalities. This study explored whether a non-timed measure of cognitive inefficiency would also be abnormal. A sample of 23 ADHD subjects was compared to 23 controls on a test that included both egocentric and allocentric visual memory subtests. A factor analysis was used to determine which cognitive variables contributed to allocentric visual memory. The ADHD sample performed significantly lower on the allocentric but not egocentric conditions. Allocentric visual memory was not associated with timed, working memory, visual perception, or mental rotation variables. This paper concluded by discussing how these results supported a cognitive inefficiency explanation for some ADHD symptoms, and discussed future research directions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Ohio QuickClear : professional responders guide for safe and effective highway incident management

DOT National Transportation Integrated Search

2007-10-01

Thousands of responders and motorists are needlessly killed or injured each year as a result of inefficient incident scene management. Traffic incidents are causing millions of hours of congestion delay annually, which results in billions of dollars ...

Inefficiencies and high-value improvements in U.S. cervical cancer screening practice: A cost-effectiveness analysis

PubMed Central

Kim, Jane J.; Campos, Nicole G.; Sy, Stephen; Burger, Emily A.; Cuzick, Jack; Castle, Philip E.; Hunt, William C.; Waxman, Alan; Wheeler, Cosette M.

2016-01-01

Background Studies suggest that cervical cancer screening practice in the United States is inefficient. The cost and health implications of non-compliance in the screening process compared to recommended guidelines are uncertain. Objective To estimate the benefits, costs, and cost-effectiveness of current cervical cancer screening practice and assess the value of screening improvements. Design Model-based cost-effectiveness analysis. Data Sources New Mexico HPV Pap Registry; medical literature. Target Population Cohort of women eligible for routine screening. Time Horizon Lifetime. Perspective Societal. Interventions Current cervical cancer screening practice; improved compliance to guidelines-based screening interval, triage testing, diagnostic referrals, and precancer treatment referrals. Outcome Measures Reductions in lifetime cervical cancer risk, quality-adjusted life-years (QALYs), lifetime costs, incremental cost-effectiveness ratios (ICERs), incremental net monetary benefits (INMBs Results of Base-Case Analysis Current screening practice was associated with lower health benefit and was not cost-effective relative to guidelines-based strategies. Improvements in the screening process were associated with higher QALYs and small changes in costs. Perfect c4mpliance to a 3-yearly screening interval and to colposcopy/biopsy referrals were associated with the highest INMBs ($759 and $741, respectively, at a willingness-to-pay threshold of $100,000 per QALY gained); together, the INMB increased to $1,645. Results of Sensitivity Analysis Current screening practice was inefficient in 100% of simulations. The rank ordering of screening improvements according to INMBs was stable over a range of screening inputs and willingness-to-pay thresholds. Limitations The impact of HPV vaccination was not considered. Conclusions The added health benefit of improving compliance to guidelines, especially the 3-yearly interval for cytology screening and diagnostic follow-up, may justify additional investments in interventions to improve U.S. cervical cancer screening practice. Funding Source U.S. National Cancer Institute. PMID:26414147

Role of the ruminal microbiome in the production and composition of milk

USDA-ARS?s Scientific Manuscript database

Environmental problems associated with animal agriculture arise primarily from inherent inefficiencies in converting energy in feeds to useful products. Attenuating these inefficiencies provides substantial potential to improve both the economics and environmental footprint of animal agriculture, pa...

Proprietary hospitals in cost containment.

PubMed

Jones, D A

1985-08-23

Any effort to control the rise in health care costs must start with analyzing the causes, which are really quite simple. Most cost control efforts fail because they do not address the causes. The causes are large subsidies in several forms that send a false message that health care is free and should be used abundantly, and expansive reimbursement programs that reward inefficient providers with higher payments. This combination of demand stimulation and cost-plus reimbursement produced the world's most expensive health care delivery system and strident calls for reform. A long overdue change in public policy took effect October 1, 1983, when Medicare payments moved from cost-plus reimbursement to fixed, prospectively determined prices. Because it addressed one of the causes of medical inflation, this change has been effective in slowing the rise in Medicare expenditures. Sponsorship of a hospital is not a determinant of its cost-effectiveness. There are examples of efficient and inefficient hospitals in both the voluntary and the investor-owned or taxpaying hospitals. The determining factor is the will of management to keep costs under control.

An architecture model for multiple disease management information systems.

PubMed

Chen, Lichin; Yu, Hui-Chu; Li, Hao-Chun; Wang, Yi-Van; Chen, Huang-Jen; Wang, I-Ching; Wang, Chiou-Shiang; Peng, Hui-Yu; Hsu, Yu-Ling; Chen, Chi-Huang; Chuang, Lee-Ming; Lee, Hung-Chang; Chung, Yufang; Lai, Feipei

2013-04-01

Disease management is a program which attempts to overcome the fragmentation of healthcare system and improve the quality of care. Many studies have proven the effectiveness of disease management. However, the case managers were spending the majority of time in documentation, coordinating the members of the care team. They need a tool to support them with daily practice and optimizing the inefficient workflow. Several discussions have indicated that information technology plays an important role in the era of disease management. Whereas applications have been developed, it is inefficient to develop information system for each disease management program individually. The aim of this research is to support the work of disease management, reform the inefficient workflow, and propose an architecture model that enhance on the reusability and time saving of information system development. The proposed architecture model had been successfully implemented into two disease management information system, and the result was evaluated through reusability analysis, time consumed analysis, pre- and post-implement workflow analysis, and user questionnaire survey. The reusability of the proposed model was high, less than half of the time was consumed, and the workflow had been improved. The overall user aspect is positive. The supportiveness during daily workflow is high. The system empowers the case managers with better information and leads to better decision making.

Effect of Common Visual Dysfunctions on Reading.

ERIC Educational Resources Information Center

McPartland, Brian P.

1985-01-01

Six common visual dysfunctions are briefly explained and their relationships to reading noted: (1) ametropia, refractive error; (2) inaccurate saccades, the small jumping eye movements used in reading; (3) inefficient binocularity/fusion; (4) insufficient convergence/divergence; (5) heterophoria, imbalance in extra-ocular muscles; and (6)…

Verbal Rehearsal and Visual Imagery: Mnemonic Aids for Learning-Disabled Children.

ERIC Educational Resources Information Center

Rose, Michael C.; And Others

1983-01-01

Studies involving 30 learning-disabled elementary students support the contention that reading comprehension difficulties among learning-disabled children are partly due to inefficient memorization strategies, and demonstrate the efficacy of practical, cost-effective mnemonic training procedures which significantly increase reading comprehension…

IMPACT OF AN INDOOR COOK STOVE INTERVENTION ON MEASURES OF SYSTEMIC INFLAMMATION

EPA Science Inventory

Background and Aims: Approximately three billion people use inefficient and poorly-vented indoor cook stoves, which can result in high indoor air pollution concentrations. Few studies have evaluated the cardiovascular effects of indoor biomass burning. Methods: In this pilot s...

Advanced scoring method of eco-efficiency in European cities.

PubMed

Moutinho, Victor; Madaleno, Mara; Robaina, Margarita; Villar, José

2018-01-01

This paper analyzes a set of selected German and French cities' performance in terms of the relative behavior of their eco-efficiencies, computed as the ratio of their gross domestic product (GDP) over their CO 2 emissions. For this analysis, eco-efficiency scores of the selected cities are computed using the data envelopment analysis (DEA) technique, taking the eco-efficiencies as outputs, and the inputs being the energy consumption, the population density, the labor productivity, the resource productivity, and the patents per inhabitant. Once DEA results are analyzed, the Malmquist productivity indexes (MPI) are used to assess the time evolution of the technical efficiency, technological efficiency, and productivity of the cities over the window periods 2000 to 2005 and 2005 to 2008. Some of the main conclusions are that (1) most of the analyzed cities seem to have suboptimal scales, being one of the causes of their inefficiency; (2) there is evidence that high GDP over CO 2 emissions does not imply high eco-efficiency scores, meaning that DEA like approaches are useful to complement more simplistic ranking procedures, pointing out potential inefficiencies at the input levels; (3) efficiencies performed worse during the period 2000-2005 than during the period 2005-2008, suggesting the possibility of corrective actions taken during or at the end of the first period but impacting only on the second period, probably due to an increasing environmental awareness of policymakers and governors; and (4) MPI analysis shows a positive technological evolution of all cities, according to the general technological evolution of the reference cities, reflecting a generalized convergence of most cities to their technological frontier and therefore an evolution in the right direction.

Effect of nitroethane, dimethyl-2-nitroglutarate and 2-nitro-methyl-propionate on ruminal methane production and hydrogen balance in vitro

USDA-ARS?s Scientific Manuscript database

Ruminal methanogenesis is considered a digestive inefficiency that results in the loss of 2-12% of the host’s gross energy intake and contributes nearly 20% to the United States’ annual CH4 emissions. Presently, the effects of the known CH4 inhibitor, nitroethane, and two synthesized nitrocompounds...

The Productivity Costs of Inefficient Hiring Practices: Evidence from Late Teacher Hiring

ERIC Educational Resources Information Center

Papay, John P.; Kraft, Matthew A.

2016-01-01

We use matched employee-employer records from the teacher labor market to explore the effects of late teacher hiring on student achievement. Hiring teachers after the school year starts reduces student achievement by 0.042 SD in mathematics and 0.026 SD in reading. This reflects, in part, a temporary disruption effect in the first year. In…

A novel suicide plasmid for efficient gene mutation in Listeria monocytogenes

USDA-ARS?s Scientific Manuscript database

Although several plasmids have been used in Listeria monocytogenes for generating mutants by allelic exchange, construction of L. monocytogenes mutants has been inefficient due to lack of effective selection markers for first and second recombination events. To address this problem, we have develope...

Vocational Training and Agricultural Productivity: Evidence from Rice Production in Vietnam

ERIC Educational Resources Information Center

Ulimwengu, John; Badiane, Ousmane

2010-01-01

The paper examines the impact of farmers' educational attainment on agricultural productivity. More specifically, it evaluates how farmers with vocational training perform compared to those with traditional educational training. A stochastic production frontier and inefficiency effects model is estimated using nationally representative household…

Scapegoating Public Schools

ERIC Educational Resources Information Center

Shaker, Paul S.; Heilman, Elizabeth E.

2008-01-01

In their popular explanation of No Child Left Behind, journalists and other public voices claim that unruly and inefficient public schools are being brought under the control of effective central authorities by scientific, test-driven accountability. Other popular themes of reform in media include mayoral control of schools, non-educators as…

Role of GnRH-II and its receptor in testicular function

USDA-ARS?s Scientific Manuscript database

The highly conserved, second mammalian isoform of gonadotropin-releasing hormone (GnRH-II) regulates the interaction between energy balance and reproductive behavior in females, as well as exhibits anti-proliferative effects on cancer cells. Furthermore, GnRH-II is an inefficient modulator of gonado...

Performance analysis of distributed applications using automatic classification of communication inefficiencies

DOEpatents

Vetter, Jeffrey S.

2005-02-01

The method and system described herein presents a technique for performance analysis that helps users understand the communication behavior of their message passing applications. The method and system described herein may automatically classifies individual communication operations and reveal the cause of communication inefficiencies in the application. This classification allows the developer to quickly focus on the culprits of truly inefficient behavior, rather than manually foraging through massive amounts of performance data. Specifically, the method and system described herein trace the message operations of Message Passing Interface (MPI) applications and then classify each individual communication event using a supervised learning technique: decision tree classification. The decision tree may be trained using microbenchmarks that demonstrate both efficient and inefficient communication. Since the method and system described herein adapt to the target system's configuration through these microbenchmarks, they simultaneously automate the performance analysis process and improve classification accuracy. The method and system described herein may improve the accuracy of performance analysis and dramatically reduce the amount of data that users must encounter.

Efficiency, cost-effectiveness and need of inversion in nutritional therapy. Importance of detecting and documenting undernutrition.

PubMed

Morán López, Jesús Manuel; Piedra León, María; Beneítez Moralejo, Belén; Enciso Izquierdo, Fidel Jesús; Luengo Pérez, Luis Miguel; Amado Señaris, José Antonio

2016-06-01

Disease Related Malnutrition (DRM) is highly prevalent in Spanish hospitals. WHO estimates that 20-40% of health-associated expenses are lost due to inefficiency. Demonstration that DRM is a component of inefficiency and hiring a specialist physician for its detection and treatment is cost-effective. Comparison between nutritional diagnosis and procedures detected and encoded at discharge using McNemar test. Recoding of 162 discharge reports including nutritional diagnoses and procedures. Determine changes on Case-Mix Index (IC), cost of procedure and cost procedure/DRG index. Comparison using T-student paired test. Only 10 of 162 diagnoses of malnutrition were coded in delivery statements (p < 0.001). After right codification, IC increased in 103,3 DRG points (p < 0.001). Consequently, procedure cost/DRG index was reduced in 978.81 € (p < 0.001). DRM is underdiagnosed in our hospital. DRM and nutritional procedures detection by a doctor specialist in clinical nutrition led to a reduction in cost procedure/DRG index of 16.8% of officially established by the Health System. Loss of 16.8% of health expenses, estimated in 424.785,15 € was described. Proper codification would have justified 343.291,2 € reimbursement just for nutritional diagnoses and processes. Both expenses were lost due to system's inefficiency. Those amounts are much higher than cost associated of hiring a specialist in clinical nutrition. Copyright © 2016 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

[Efficiency, cost-effectiveness and justification of need for investment in nutrition therapy in a hospital of third level; the role of specialists in endocrinology and nutrition and the coding unit].

PubMed

Morán López, Jesús Manuel; Enciso Izquierdo, Fidel Jesús; Beneítez Moralejo, Belén; Luengo Pérez, Luis Miguel; Piedra León, María; Amado Señaris, José Antonio

2015-04-01

Disease Related Malnutrition (DRM) is highly prevalent in Spanish hospitals. WHO estimates that 20-40% of health-associated expenses are lost due to inefficiency. Demonstration that DRM is a component of inefficiency and hiring a specialist physician for its detection and treatment is cost-effective. Comparison between nutritional diagnosis and procedures detected and encoded at discharge using McNemar test. Recoding of 55 discharge reports including nutritional diagnoses and procedures. Determine changes on Case-Mix Index (IC), cost of procedure and cost procedure/GRD index. Comparison using Wilcoxon test. Only 2 of 55 diagnoses of malnutrition were coded in delivery statements (p<0,001). After right codification,IC increased in 42,67 GRD points (p<0,05). Consequently, procedure cost/GRD index was reduced in 976,81€ (p<0,05). DRM is underdiagnosed in our hospital. DRM and nutritional procedures detection by a specialist on endocrinology and nutrition led to a reduction in cost procedure/GRD index of 20% of officially established by the Health System. Loss of 20% of health expenses,estimated in 172690€ was described. Proper codification would have justified 154581€ reimbursement just for nutritional diagnoses and processes. Both expenses were lost due to system's inefficiency. Those amounts are much higher than cost associated of hiring a specialist, so there is no economic reason for denying it. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Effect of virtual memory on efficient solution of two model problems

NASA Technical Reports Server (NTRS)

Lambiotte, J. J., Jr.

1977-01-01

Computers with virtual memory architecture allow programs to be written as if they were small enough to be contained in memory. Two types of problems are investigated to show that this luxury can lead to quite an inefficient performance if the programmer does not interact strongly with the characteristics of the operating system when developing the program. The two problems considered are the simultaneous solutions of a large linear system of equations by Gaussian elimination and a model three-dimensional finite-difference problem. The Control Data STAR-100 computer runs are made to demonstrate the inefficiencies of programming the problems in the manner one would naturally do if the problems were indeed, small enough to be contained in memory. Program redesigns are presented which achieve large improvements in performance through changes in the computational procedure and the data base arrangement.

Environmental issues and economic performance of the coal industry in Brazil

DOE Office of Scientific and Technical Information (OSTI.GOV)

Santana, E.A.; Seabra, F.; Wendhausen, J.

1996-12-31

The purpose of this study is to investigate the main sources of inefficiency of the Brazilian coal industry. In addition, the authors examine the current and the future competitiveness of the Brazilian coal industry taking into account the effects of globalization, the modernization of the mining techniques and, most important, the environmental costs regarded under the concept of sustainable development. This paper examines some of the causes behind the alleged inefficiency of coal production and coal-electric generation, with special emphasis to environmental issues. The rest of the paper is organized as follows. Section 2 outlines a profile of the energeticmore » potential of coal reserves in Brazil. In section 3, the authors discuss environmental restrictions and other features that can be related to the performance of the coal industry in Brazil.« less

Mediation of adoption and use: a key strategy for mitigating unintended consequences of health IT implementation.

PubMed

Novak, Laurie L; Anders, Shilo; Gadd, Cynthia S; Lorenzi, Nancy M

2012-01-01

Without careful attention to the work of users, implementation of health IT can produce new risks and inefficiencies in care. This paper uses the technology use mediation framework to examine the work of a group of nurses who serve as mediators of the adoption and use of a barcode medication administration (BCMA) system in an inpatient setting. The study uses ethnographic methods to explore the mediators' work. Data included field notes from observations, documents, and email communications. This variety of sources enabled triangulation of findings between activities observed, discussed in meetings, and reported in emails. Mediation work integrated the BCMA tool with nursing practice, anticipating and solving implementation problems. Three themes of mediation work include: resolving challenges related to coordination, integrating the physical aspects of BCMA into everyday practice, and advocacy work. Previous work suggests the following factors impact mediation effectiveness: proximity to the context of use, understanding of users' practices and norms, credibility with users, and knowledge of the technology and users' technical abilities. We describe three additional factors observed in this case: 'influence on system developers,' 'influence on institutional authorities,' and 'understanding the network of organizational relationships that shape the users' work.' Institutionally supported clinicians who facilitate adoption and use of health IT systems can improve the safety and effectiveness of implementation through the management of unintended consequences. Additional research on technology use mediation can advance the science of implementation by providing decision-makers with theoretically durable, empirically grounded evidence for designing implementations.

Are Public Enterprises Inefficient?: Viewpoints of Western Scholars

ERIC Educational Resources Information Center

Fuqian, Fang

2006-01-01

People who advocate the privatization of public enterprises generally maintain that these enterprises, compared with private enterprises, have the following shortcomings: (1) public enterprises do not produce in response to consumer needs; (2) they use too much capital on inefficient production; (3) production often experiences breakdowns and…

Inefficient Self-Selection into Education and Wage Inequality

ERIC Educational Resources Information Center

Ordine, Patrizia; Rose, Giuseppe

2011-01-01

This paper proposes a theoretical framework where "within graduates" wage inequality is related to overeducation/educational mismatch in the labor market. We show that wage inequality may arise because of inefficient self-selection into education in the presence of ability-complementary technological progress and asymmetric information…

Modeling the Adoption Process of the Flight Training Synthetic Environment Technology (FTSET) in the Turkish Army Aviation (TUAA)

DTIC Science & Technology

2006-12-01

meet expectations. Moreover, instead of establishing cost-effective training, resources would be consumed inefficiently. Marketing and advertising are...earlier the involvement of an end user, the better a product’s design and the faster its technology adoption. Marketing and advertising techniques

Testing nonlocal realism with entangled coherent states

DOE Office of Scientific and Technical Information (OSTI.GOV)

Paternostro, Mauro; Jeong, Hyunseok

2010-03-15

We investigate the violation of nonlocal realism using entangled coherent states (ECSs) under nonlinear operations and homodyne measurements. We address recently proposed Leggett-type inequalities, including a class of optimized incompatibility inequalities proposed by Branciard et al. [Nature Phys. 4, 681 (2008)], and thoroughly assess the effects of detection inefficiency.

Memory and Rehearsal Characteristics of Profoundly Deaf Children.

ERIC Educational Resources Information Center

Bebko, James M.

1984-01-01

Tests 64 deaf students from oral and total communication settings to examine whether a deficiency in spontaneous strategy use accounts for their verbal short-term memory performance. Spontaneous rehearsal of both deaf samples seemed to emerge later than the hearing sample's and was inefficiently implemented and less effective in mediating recall…

Techniques for measuring animal physiological and behavioral responses with respect to the environment

USDA-ARS?s Scientific Manuscript database

Environmental effects cause animal production inefficiencies and animal well-being issues. Thus, many experiments have been designed to understand thermal stress and to test different means to relieve it. There are multiple physiological responses and behavior/activities that can be measured to di...

ALTERNATIVE PUBLIC SCHOOL SYSTEMS--A RESPONSE TO AMERICA'S EDUCATIONAL EMERGENCY.

ERIC Educational Resources Information Center

CLARK, KENNETH B.

AMERICAN PUBLIC EDUCATION HAS BEEN INEFFICIENT AND UNEQUAL AND HAS EFFECTIVELY BLOCKED ECONOMIC AND SOCIAL MOBILITY FOR NEGROES. CHANGE AND IMPROVEMENT HAVE BEEN IMPEDED BY DOGMAS ABOUT THE INVIOLABILITY OF THE NEIGHBORHOOD SCHOOL, BY ADMINISTRATIVE BARRIERS, AND BY DEEP-SEATED PSYCHOLOGICAL PREJUDICES. COMPENSATORY EDUCATION PROGRAMS IN…

Depth and Elaboration of Processing in Relation to Age.

ERIC Educational Resources Information Center

Simon, Eileen

1979-01-01

The recall effectiveness of semantic and phonemic cues was compared to uncover the pattern of deep and elaborate processing in relation to age and experimental treatment. It was concluded that aging results in poor elaboration, especially in inefficient integration of word events with the context of presentation. (Author/CP)

Harvesting the High-Hanging Fruit

ERIC Educational Resources Information Center

Kenton, Jay D.

2014-01-01

For many years, higher education institutions have been harvesting the low-hanging fruit when it comes to budget reductions and adjustments. Easier changes have often been made--such as cutting administration, using more adjunct faculty, contracting out inefficient or non effective auxiliary operations and so forth. Until recently such strategies,…

Deconstructing the Myth of American Public Schooling Inefficiency

ERIC Educational Resources Information Center

Baker, Bruce D.; Weber, Mark

2016-01-01

In this paper, the authors begin by classifying the arguments that assert American schools are relatively inefficient into two categories: the "long-term trend argument" and the "international comparison argument." Their focus herein is on the latter of these two. They then describe two frameworks for approaching either of…

Budgeting in health care systems.

PubMed

Maynard, A

1984-01-01

During the last decade there has been a recognition that all health care systems, public and private, are characterised by perverse incentives (especially moral hazard and third party pays) which generate inefficiency in the use of scarce economic resources. Inefficiency is unethical: doctors who use resources inefficiently deprive potential patients of care from which they could benefit. To eradicate unethical and inefficient practices two economic rules have to be followed: (i) no service should be provided if its total costs exceed its total benefits; (ii) if total benefits exceed total costs, the level of provision should be at that level at which the additional input cost (marginal cost) is equal to the additional benefits (marginal benefit). This efficiency test can be applied to health care systems, their component parts and the individuals (especially doctors) who control resource allocation within them. Unfortunately, all health care systems neither generate this relevant decision making data nor are they flexible enough to use it to affect health care decisions. There are two basic varieties of budgeting system: resource based and production targeted. The former generates obsession with cash limits and too little regard of the benefits, particularly at the margins, of alternative patterns of resource allocation. The latter generates undue attention to the production of processes of care and scant regard for costs, especially at the margins. Consequently, one set of budget rules may lead to cost containment regardless of benefits and the other set of budget rules may lead to output maximization regardless of costs. To close this circle of inefficiency it is necessary to evolve market-like structures. To do this a system of client group (defined broadly across all existing activities public and private) budgets is advocated with an identification of the budget holder who has the capacity to shift resources and seek out cost effective policies. Negotiated output targets with defined budgets and incentives for decision makers to economise in their use of resources are being incorporated into experiments in the health care systems of Western Europe and the United States. Undue optimism about the success of these experiments must be avoided because these problems have existed in the West and in the Soviet bloc for decades and efficient solutions are noticeable by their absence.

Effectiveness of Kanban Approaches in Systems Engineering within Rapid Response Environments

DTIC Science & Technology

2012-01-01

Procedia Computer Science Procedia Computer Science 00 (2012) 000–000 www.elsevier.com/locate/ procedia New Challenges in Systems...Author name / Procedia Computer Science 00 (2011) 000–000 inefficient use of resources. The move from ―one step to glory‖ system initiatives to...University of Science and Technology Effectiveness of kanban approaches in systems engineering within rapid response environments Richard Turner

Factors influencing the work efficiency of district health managers in low-resource settings: a qualitative study in Ghana.

PubMed

Bonenberger, Marc; Aikins, Moses; Akweongo, Patricia; Wyss, Kaspar

2016-01-14

There is increasing evidence that good district management practices can improve health system performance and conversely, that poor and inefficient management practices have detrimental effects. The aim of the present study was to identify factors contributing to inefficient management practices of district health managers and ways to improve their overall efficiency. Nineteen semi-structured interviews were conducted with district health managers in three districts of the Eastern Region in Ghana. The 19 interviews conducted comprised 90% of the managerial workforce in these districts in 2013. A thematic analysis was carried out using the WHO's leadership and management strengthening framework to structure the results. Key factors for inefficient district health management practices were identified to be: human resource shortages, inadequate planning and communication skills, financial constraints, and a narrow decision space that constrains the authority of district health managers and their ability to influence decision-making. Strategies that may improve managerial efficiency at both an individual and organizational level included improvements to planning, communication, and time management skills, and ensuring the timely release of district funds. Filling District Health Management Team vacancies, developing leadership and management skills of district health managers, ensuring a better flow of district funds, and delegating more authority to the districts seems to be a promising intervention package, which may result in better and more efficient management practices and stronger health system performance.

Installation-Wide Energy Conservation Demonstration at Fort McClellan, Alabama

DTIC Science & Technology

1988-11-01

Inefficient Electrical Motors 12 Dispensary Chiller Installation 12 Combustion Optimization of Gas-fired Heating Equipment 12 Infiltration Study of Family... Chiller Installation 34 5 FAMILY HOUSING .................................................... 37 Combustion Optimization of Gas-fired Heating...in Outdoor Air Ventilation 59 Replacement of Inefficient Electric Motors 59 Dispensary Chiller Installation 60 Combustion Optimization of Gas-fired

Measurement and investigation of proton irradiation-induced charge transfer inefficiency in PPD CIS at different integration times

NASA Astrophysics Data System (ADS)

Xue, Yuanyuan; Wang, Zujun; Zhang, Fengqi; Bian, Jingying; Yao, Zhibin; He, Baoping; Liu, Minbo; Sheng, Jiangkun; Ma, Wuying; Dong, Guantao; Jin, Junshan

2018-04-01

Charge transfer inefficiency (CTI) is an important parameter for photodiode (PPD) CMOS image sensors (CISs). A test system was built and used to measure the CTI of PPD CIS devices at different integration times. The radiation effects of 3 MeV and 10 MeV protons on the CTI were investigated. The experiments were carried out at the EN Tandem Van de Graaff accelerator at proton fluences in the range 1010 to 1011 p/cm2. The CTI was measured within the 2 h following proton radiations. The dependence of CTI on integration time, proton energy and fluence were investigated. The CTI was observed to increase after proton irradiation: with the effect of irradiation with 3 MeV proton being more severe than that with 10 MeV protons. The CTI was also observed to decrease with increasing integration time, which is thought to be related to the charge density in the space charge region (SCR) of the CIS devices. This work has provided a simple method to measure the CTI and helped us to understand proton radiation effects on the CTI of PPD CISs.

Combustion characteristics of lodge pole pine wood chips. Technical progress report No. 15, September 16, 1978-September 15, 1979

DOE Office of Scientific and Technical Information (OSTI.GOV)

Junge, D.C.

1979-09-01

Significant quantits of wood resiue fuels are presently being used in industrial steam generating facilities. Recent studies indicate that substantial additional quantities of wood residue fuels are available for energy generation in the form of steam and/or electricity. A limited data base on the combustion characteristics of wood residue fuels has resulted in the installation and operation of inefficient combustion systems for these fuels. This investigation of the combustion characteristics of wood residue fuels was undertaken to provide a data base which could be used to optimize the combustion of such fuels. Optimization of the combustion process in industrial boilersmore » serves to improve combustion efficiency and to reduce air pollutant emissions generated in the combustion process. This report presents data on the combustion characteristics of lodge pole pine wood chips. The data were obtained in a pilot scale combustion test facility at Oregon State University.« less

Selling Complementary Patents: Experimental Investigation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bjornstad, David J; Santore, Rudy; McKee, Michael

2010-02-01

Production requiring licensing groups of complementary patents implements a coordination game among patent holders, who can price patents by choosing among combinations of fixed and royalty fees. Summed across patents, these fees become the total producer cost of the package of patents. Royalties, because they function as excise taxes, add to marginal costs, resulting in higher prices and reduced quantities of the downstream product and lower payoffs to the patent holders. Using fixed fees eliminates this inefficiency but yields a more complex coordination game in which there are multiple equilibria, which are very fragile in that small mistakes can leadmore » the downstream firm to not license the technology, resulting in inefficient outcomes. We report on a laboratory market investigation of the efficiency effects of coordinated pricing of patents in a patent pool. We find that pool-like pricing agreements can yield fewer coordination failures in the pricing of complementary patents.« less

Systems Engineering Knowledge Asset (SEKA) Management for Higher Performing Engineering Teams: People, Process and Technology toward Effective Knowledge-Workers

ERIC Educational Resources Information Center

Shelby, Kenneth R., Jr.

2013-01-01

Systems engineering teams' value-creation for enterprises is slower than possible due to inefficiencies in communication, learning, common knowledge collaboration and leadership conduct. This dissertation outlines the surrounding people, process and technology dimensions for higher performing engineering teams. It describes a true experiment…

Effects of Mindfulness Meditation on Three Individuals with Aphasia

ERIC Educational Resources Information Center

Orenstein, Ellen; Basilakos, Alexandra; Marshall, Rebecca Shisler

2012-01-01

Background: There is evidence to suggest that people with aphasia (PWA) may have deficits in attention stemming from the inefficient allocation of resources. The inaccurate perception of task demand, or sense of effort, may underlie the misallocation of the available attention resources. Given the lack of treatment options for improving attention…

Long-term effects of compost and cover crops on soil phosphorus in two California agroecosystems

USDA-ARS?s Scientific Manuscript database

Inefficient P use in agriculture results in soil P accumulation and losses to surrounding ecosystems, highlighting the need to reduce external inputs and use them more efficiently. Composts reduce the need for mineral fertilizers by recycling P from wastes at the regional scale, whereas cover crops ...

USE OF HIGH CONTENT IMAGE ANALYSES TO DETECT CHEMICAL-MEDIATED EFFECTS ON NEURITE SUB-POPULATIONS IN PRIMARY RAT CORTICAL NEURONS

EPA Science Inventory

Traditional developmental neurotoxicity tests performed in vivo are costly, time-consuming and utilize a large number of animals. In order to address these inefficiencies, in vitro models of neuronal development have been used in a first tier screening approach for developmenta...

77 FR 33256 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-05

...-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate Effectiveness of... is hereby given that on May 22, 2012, The NASDAQ Stock Market LLC (``NASDAQ'' or ``Exchange'') filed... Order Fee,\\3\\ aimed at reducing inefficient order entry practices of certain market participants that...

Sirtuin-3 (SIRT3) protein attenuates doxorubicin-induced oxidative stress and improves mitochondrial respiration in H9c2 cardiomyocytes

USDA-ARS?s Scientific Manuscript database

Doxorubicin (DOX) is a chemotherapeutic agent effective in the treatment of many cancers. However, cardiac dysfunction caused by DOX limits its clinical use. DOX is believed to be harmful to cardiomyocytes by interfering with the mitochondrial phospholipid cardiolipin and causing inefficient electro...

Negative emotional stimuli reduce contextual cueing but not response times in inefficient search.

PubMed

Kunar, Melina A; Watson, Derrick G; Cole, Louise; Cox, Angeline

2014-02-01

In visual search, previous work has shown that negative stimuli narrow the focus of attention and speed reaction times (RTs). This paper investigates these two effects by first asking whether negative emotional stimuli narrow the focus of attention to reduce the learning of a display context in a contextual cueing task and, second, whether exposure to negative stimuli also reduces RTs in inefficient search tasks. In Experiment 1, participants viewed either negative or neutral images (faces or scenes) prior to a contextual cueing task. In a typical contextual cueing experiment, RTs are reduced if displays are repeated across the experiment compared with novel displays that are not repeated. The results showed that a smaller contextual cueing effect was obtained after participants viewed negative stimuli than when they viewed neutral stimuli. However, in contrast to previous work, overall search RTs were not faster after viewing negative stimuli (Experiments 2 to 4). The findings are discussed in terms of the impact of emotional content on visual processing and the ability to use scene context to help facilitate search.

Adiabatic theory for the population distribution in the evolutionary minority game

NASA Astrophysics Data System (ADS)

Chen, Kan; Wang, Bing-Hong; Yuan, Baosheng

2004-02-01

We study the evolutionary minority game (EMG) using a statistical mechanics approach. We derive a theory for the steady-state population distribution of the agents. The theory is based on an “adiabatic approximation” in which short time fluctuations in the population distribution are integrated out to obtain an effective equation governing the steady-state distribution. We discover the mechanism for the transition from segregation (into opposing groups) to clustering (towards cautious behaviors). The transition is determined by two generic factors: the market impact (of the agents’ own actions) and the short time market inefficiency (arbitrage opportunities) due to fluctuations in the numbers of agents using opposite strategies. A large market impact favors “extreme” players who choose fixed opposite strategies, while large market inefficiency favors cautious players. The transition depends on the number of agents (N) and the effective rate of strategy switching. When N is small, the market impact is relatively large; this favors the extreme behaviors. Frequent strategy switching, on the other hand, leads to a clustering of the cautious agents.

Environmental Assessment of Installation Development at MacDill Air Force Base, Florida

DTIC Science & Technology

2013-04-18

and west of MacDill AFB classified as Class II waters. Class III is designated for Fish Consumption , Recreation, Propagation and maintenance of a...beneficial effects would be expected due to the selected projects by demolishing old buildings with outdated water fixtures with inefficient water consumption ...long-term increase in water consumption would be expected. Sanitary Sewer and Wastewater Treatment. Short-term, negligible, adverse effects on the

The relation between input-output transformation and gastrointestinal nematode infections on dairy farms.

PubMed

van der Voort, M; Van Meensel, J; Lauwers, L; Van Huylenbroeck, G; Charlier, J

2016-02-01

Efficiency analysis is used for assessing links between technical efficiency (TE) of livestock farms and animal diseases. However, previous studies often do not make the link with the allocation of inputs and mainly present average effects that ignore the often huge differences among farms. In this paper, we studied the relationship between exposure to gastrointestinal (GI) nematode infections, the TE and the input allocation on dairy farms. Although the traditional cost allocative efficiency (CAE) indicator adequately measures how a given input allocation differs from the cost-minimising input allocation, they do not represent the unique input allocation of farms. Similar CAE scores may be obtained for farms with different input allocations. Therefore, we propose an adjusted allocative efficiency index (AAEI) to measure the unique input allocation of farms. Combining this AAEI with the TE score allows determining the unique input-output position of each farm. The method is illustrated by estimating efficiency scores using data envelopment analysis (DEA) on a sample of 152 dairy farms in Flanders for which both accountancy and parasitic monitoring data were available. Three groups of farms with a different input-output position can be distinguished based on cluster analysis: (1) technically inefficient farms, with a relatively low use of concentrates per 100 l milk and a high exposure to infection, (2) farms with an intermediate TE, relatively high use of concentrates per 100 l milk and a low exposure to infection, (3) farms with the highest TE, relatively low roughage use per 100 l milk and a relatively high exposure to infection. Correlation analysis indicates for each group how the level of exposure to GI nematodes is associated or not with improved economic performance. The results suggest that improving both the economic performance and exposure to infection seems only of interest for highly TE farms. The findings indicate that current farm recommendations regarding GI nematode infections could be improved by also accounting for the allocation of inputs on the farm.

Homocores, Cores and Operational Inefficiency in Superadditive N-Person Games.

DTIC Science & Technology

1983-02-01

MICROCOPY RESOLUTION TEST CHART NATIONAL BUREAU OF STANDARDS -963-A ’I .. . Re,, arch Report CCS 456 HOMOCO.S S, WOkLS AND OPLP AI [OW \\l INEFFICIENCY...modifications were made in L. Johanssen’s working papers at The Econometric Institute of The University of Oslo in 1981 and in Aumann [1981]. Yet we know

Design Tools for Evaluating Multiprocessor Programs

DTIC Science & Technology

1976-07-01

than large uniprocessing machines, and 2. economies of scale in manufacturing. Perhaps the most compelling reason (possibly a consequence of the...speed, redundancy, (inefficiency, resource utilization, and economies of the components. [Browne 73, Lehman 66] 6. How can the system be scheduled...mejsures are interesting about the computation? Somn may be: speed, redundancy, (inefficiency, resource utilization, and economies of the components

33 CFR 55.11 - How are child development center fees established?

Code of Federal Regulations, 2010 CFR

2010-07-01

... each Command with responsibility for a center-based program, according to the following total family income chart: Total Family Income $0 to $23,000 $23,001 to $34,000 $34,001 to $44,000 $44,001 to $55,000... care, unless it is uneconomical and inefficient. If uneconomical and inefficient, then the fees may be...

Modeling cross-correlations and efficiency of Islamic and conventional banks from Saudi Arabia: Evidence from MF-DFA and MF-DXA approaches

NASA Astrophysics Data System (ADS)

Mensi, Walid; Hamdi, Atef; Shahzad, Syed Jawad Hussain; Shafiullah, Muhammad; Al-Yahyaee, Khamis Hamed

2018-07-01

This paper analyzes the dynamic efficiency and interdependence of Islamic and conventional banks of Saudi Arabia. This analysis applies the Multifractal Detrended Fluctuation Analysis (MF-DFA) and Multifractal Detrended Cross-Correlation Analysis (MF-DXA) approaches. The MF-DFA results show strong multifractality in the daily returns of Saudi banks. Moreover, all eight banks studied exhibit persistence correlation, which demonstrates inefficiency. The rolling window results show significant change in the inefficiency levels over the time. The cross-correlation analysis between bank-pairs exhibits long term interdependence between most of them. These findings indicate that the banking sector in Saudi Arabia suffers from inefficiency and exhibits long term memory.

A qualitative study of governance of evolving response to non-communicable diseases in low-and middle- income countries: current status, risks and options.

PubMed

Rani, Manju; Nusrat, Sharmin; Hawken, Laura H

2012-10-16

Segmented service delivery with consequent inefficiencies in health systems was one of the main concerns raised during scaling up of disease-specific programs in the last two decades. The organized response to NCD is in infancy in most LMICs with little evidence on how the response is evolving in terms of institutional arrangements and policy development processes. Drawing on qualitative review of policy and program documents from five LMICs and data from global key-informant surveys conducted in 2004 and 2010, we examine current status of governance of response to NCDs at national level along three dimensions- institutional arrangements for stewardship and program management and implementation; policies/plans; and multisectoral coordination and partnerships. Several positive trends were noted in the organization and governance of response to NCDs: shift from specific NCD-based programs to integrated NCD programs, increasing inclusion of NCDs in sector-wide health plans, and establishment of high-level multisectoral coordination mechanisms.Several areas of concern were identified. The evolving NCD-specific institutional structures are being treated as 'program management and implementation' entities rather than as lead 'technical advisory' bodies, with unclear division of roles and responsibilities between NCD-specific and sector-wide structures. NCD-specific and sector-wide plans are poorly aligned and lack prioritization, costing, and appropriate targets. Finally, the effectiveness of existing multisectoral coordination mechanisms remains questionable. The 'technical functions' and 'implementation and management functions' should be clearly separated between NCD-specific units and sector-wide institutional structures to avoid duplicative segmented service delivery systems. Institutional capacity building efforts for NCDs should target both NCD-specific units (for building technical and analytical capacity) and sector-wide organizational units (for building program management and implementation capacity) in MOH.The sector-wide health plans should reflect NCDs in proportion to their public health importance. NCD specific plans should be developed in close consultation with sector-wide health- and non-health stakeholders. These plans should expand on the directions provided by sector-wide health plans specifying strategically prioritized, fully costed activities, and realistic quantifiable targets for NCD control linked with sector-wide expenditure framework. Multisectoral coordination mechanisms need to be strengthened with optimal decision-making powers and resource commitment and monitoring of their outputs.

A qualitative study of governance of evolving response to non-communicable diseases in low-and middle- income countries: current status, risks and options

PubMed Central

2012-01-01

Background Segmented service delivery with consequent inefficiencies in health systems was one of the main concerns raised during scaling up of disease-specific programs in the last two decades. The organized response to NCD is in infancy in most LMICs with little evidence on how the response is evolving in terms of institutional arrangements and policy development processes. Methods Drawing on qualitative review of policy and program documents from five LMICs and data from global key-informant surveys conducted in 2004 and 2010, we examine current status of governance of response to NCDs at national level along three dimensions— institutional arrangements for stewardship and program management and implementation; policies/plans; and multisectoral coordination and partnerships. Results Several positive trends were noted in the organization and governance of response to NCDs: shift from specific NCD-based programs to integrated NCD programs, increasing inclusion of NCDs in sector-wide health plans, and establishment of high-level multisectoral coordination mechanisms. Several areas of concern were identified. The evolving NCD-specific institutional structures are being treated as ‘program management and implementation’ entities rather than as lead ‘technical advisory’ bodies, with unclear division of roles and responsibilities between NCD-specific and sector-wide structures. NCD-specific and sector-wide plans are poorly aligned and lack prioritization, costing, and appropriate targets. Finally, the effectiveness of existing multisectoral coordination mechanisms remains questionable. Conclusions The ‘technical functions’ and ‘implementation and management functions’ should be clearly separated between NCD-specific units and sector-wide institutional structures to avoid duplicative segmented service delivery systems. Institutional capacity building efforts for NCDs should target both NCD-specific units (for building technical and analytical capacity) and sector-wide organizational units (for building program management and implementation capacity) in MOH. The sector-wide health plans should reflect NCDs in proportion to their public health importance. NCD specific plans should be developed in close consultation with sector-wide health- and non-health stakeholders. These plans should expand on the directions provided by sector-wide health plans specifying strategically prioritized, fully costed activities, and realistic quantifiable targets for NCD control linked with sector-wide expenditure framework. Multisectoral coordination mechanisms need to be strengthened with optimal decision-making powers and resource commitment and monitoring of their outputs. PMID:23067232

Addressing Unison and Uniqueness of Reliability and Safety for Better Integration

NASA Technical Reports Server (NTRS)

Huang, Zhaofeng; Safie, Fayssal

2015-01-01

For a long time, both in theory and in practice, safety and reliability have not been clearly differentiated, which leads to confusion, inefficiency, and sometime counter-productive practices in executing each of these two disciplines. It is imperative to address the uniqueness and the unison of these two disciplines to help both disciplines become more effective and to promote a better integration of the two for enhancing safety and reliability in our products as an overall objective. There are two purposes of this paper. First, it will investigate the uniqueness and unison of each discipline and discuss the interrelationship between the two for awareness and clarification. Second, after clearly understanding the unique roles and interrelationship between the two in a product design and development life cycle, we offer suggestions to enhance the disciplines with distinguished and focused roles, to better integrate the two, and to improve unique sets of skills and tools of reliability and safety processes. From the uniqueness aspect, the paper identifies and discusses the respective uniqueness of reliability and safety from their roles, accountability, nature of requirements, technical scopes, detailed technical approaches, and analysis boundaries. It is misleading to equate unreliable to unsafe, since a safety hazard may or may not be related to the component, sub-system, or system functions, which are primarily what reliability addresses. Similarly, failing-to-function may or may not lead to hazard events. Examples will be given in the paper from aerospace, defense, and consumer products to illustrate the uniqueness and differences between reliability and safety. From the unison aspect, the paper discusses what the commonalities between reliability and safety are, and how these two disciplines are linked, integrated, and supplemented with each other to accomplish the customer requirements and product goals. In addition to understanding the uniqueness in reliability and safety, a better understanding of unison and commonalities will further help in understanding the interaction between reliability and safety. This paper discusses the unison and uniqueness of reliability and safety. It presents some suggestions for better integration of the two disciplines in terms of technical approaches, tools, techniques, and skills to enhance the role of reliability and safety in supporting a product design and development life cycle. The paper also discusses eliminating the redundant effort and minimizing the overlap of reliability and safety analyses for an efficient implementation of the two disciplines.

Military Hybrid Vehicle Survey

DTIC Science & Technology

2011-08-03

III Composite 4.3% Integrated starter generator for engine shut down, regenerative braking and avoidance of inefficient engine operation [28]. FMTV...eliminating the inefficiencies associated with idling, vehicle braking and low engine speed part load efficiency, many improvements can be realized...literature. They can be divided into the following two categories : (1) Time dependent speed profiles, shown in Figure 4, usually defined by the federal

Current State of Military Hybrid Vehicle Development

DTIC Science & Technology

2011-08-31

Integrated starter generator for engine shut down, regenerative braking and avoidance of inefficient engine operation [28]. FMTV VI Composite 6-9% Fuel...and eliminating the inefficiencies associated with idling, vehicle braking and low engine speed part load efficiency, many improvements could be...different drive cycles were being used to evaluate vehicle performance. These cycles can be divided into the following two categories : (1) Time

A Study on the Reasons for the Inefficiency of College English Teaching and Some Tentative Countermeasures

ERIC Educational Resources Information Center

Wang, Zhaogang

2014-01-01

On the basis of a survey, the reasons for the inefficiency of current College English teaching are examined. First, the traditional learning methodology is entrenched and the concepts and ideology of language teaching are outdated. Second, the social and learning environment resulted in the conflicts between the purpose of English teaching and the…

Energy Technology Investments: Maximizing Efficiency Through a Maritime Energy Portfolio Interface and Decision Aid

DTIC Science & Technology

2012-02-09

Investment (ROI) and Break Even Point ( BEP ). These metrics are essential for determining whether an initiative would be worth pursuing. Balanced...is Unlimited Energy Decision Framework Identify Inefficiencies 2. Perform Analyses 3. Examine Technology Candidates 1. Improve Energy...Unlimited Energy Decision Framework Identify Inefficiencies 2. Perform Analyses 3. Examine Technology Candidates 1. Improve Energy Efficiency 4

Improving Efficiency of Teaching the Tatar Language to a Foreign Audience

ERIC Educational Resources Information Center

Abdullazyanovich, Yusupov Ruzal; Hanipovna, Aydarova Svetlana; Kamilovna, Sagdieva Ramilya; Faritovna, Harisova Gulnaz

2015-01-01

In the article we consider the state of teaching the Tatar language in Russian schools as one of the two official languages in the Republic of Tatarstan, we reveal reasons for teaching inefficiency of this language in schools, and give recommendations aimed at improving the effectiveness of teaching of the Tatar language, improving teaching…

The Effects of Individual Differences on Learner's Navigation in a Courseware

ERIC Educational Resources Information Center

Somyürek, Sibel; Güyer, Tolga; Atasoy, Bilal

2008-01-01

One of the major features of a computer based instruction (CBI) is its non-linear structure allowing learners the opportunity of flexible navigation to accommodate their own needs. However, this non-linear structure may cause problems such as inefficient navigation, being lost or cognitive overhead for some learners. The aim of this study is to…

Characterising resource use and potential inefficiencies during large-fire suppression in the western US

Treesearch

Hari Katuwal; Christopher J. Dunn; David E. Calkin

2017-01-01

Currently, limited research on large-fire suppression effectiveness suggests fire managers may over-allocate resources relative to values to be protected. Coupled with observations that weather may be more important than resource abundance to achieve control objectives, resource use may be driven more by risk aversion than efficiency. To explore this potential, we...

You Can Get There from Here: The Road to Downsizing in Higher Education.

ERIC Educational Resources Information Center

Butterfield, Barbara S.; Wolfe, Susan

This book approaches college and university budget reduction mandates as an opportunity to reexamine and recast outdated, inefficient processes and to increase administrative effectiveness and efficiency in supporting the academic missions of teaching and research. The book uses a road-map metaphor to tell the downsizing story and to advance the…

Weed management practice and cropping sequence impact on soil residual nitrogen

USDA-ARS?s Scientific Manuscript database

Inefficient N uptake by crops from N fertilization and/or N mineralized from crop residue and soil organic matter results in the accumulation of soil residual N (NH4-N and NO3-N) which increases the potential for N leaching. The objective of this study was to evaluate the effects of weed management ...

Public Costs, Relative Subsidies, and Repayment Burdens of Federal US Student Loan Plans: Lessons for Reform

ERIC Educational Resources Information Center

Hauser, Daniel C.; Johnston, Alison

2016-01-01

American students graduate from college with tens of thousands of dollars in debt, leading to substantial repayment burdens and potentially inefficient shifts in spending patterns and career choices. A political trend towards austerity coupled with the rising student debt make the effective allocation of federal higher education resources and…

A Framework for Quantitative Evaluation of Care Coordination Effectiveness

ERIC Educational Resources Information Center

Liu, Wei

2017-01-01

The U.S. healthcare system lacks incentives and quantitative evaluation tools to assess coordination in a patient's care transition process. This is needed because poor care coordination has been identified by many studies as one of the major root causes for the U.S. health system's inefficiency, for poor outcomes, and for high cost. Despite…

Effect of Mastery Learning on Senior Secondary School Students' Cognitive Learning Outcome in Quantitative Chemistry

ERIC Educational Resources Information Center

Mitee, Telimoye Leesi; Obaitan, Georgina N.

2015-01-01

The cognitive learning outcome of Senior Secondary School chemistry students has been poor over the years in Nigeria. Poor mathematical skills and inefficient teaching methods have been identified as some of the major reasons for this. Bloom's theory of school learning and philosophy of mastery learning assert that virtually all students are…

Suppression of AGN-Driven Turbulence by Magnetic Fields in a Magnetohydrodynamic Model of the Intracluster Medium

NASA Astrophysics Data System (ADS)

Bambic, Christopher J.; Morsony, Brian; Reynolds, Christopher S.

2018-01-01

We investigate the role of AGN feedback in turbulent heating of galaxy clusters. Specifically, we analyze the production of turbulence by g-modes generated by the supersonic expansion and buoyant rise of AGN-driven bubbles. Previous work which neglects magnetic fields has shown that this process is inefficient, with less than 1% of the injected energy ending up in turbulence. This inefficiency is primarily due to the fact that the bubbles are shredded apart by hydrodynamic instabilities before they can excite sufficiently strong g-modes. Using a plane-parallel model of the ICM and 3D ideal MHD simulations, we examine the role of a large-scale magnetic field which is able to drape around these rising bubbles, preserving them from hydrodynamic instabilities. We find that, while magnetic draping appears better able to preserve AGN-driven bubbles, the driving of g-modes and the resulting production of turbulence is still inefficient. The magnetic tension force prevents g-modes from transitioning into the nonlinear regime, suppressing turbulence in our model ICM below levels measured in hydrodynamic simulations. Our work highlights the ways in which ideal MHD is an insufficient description for the cluster feedback process, and we discuss future work such as the inclusion of anisotropic viscosity as a means of simulating high β plasma kinetic effects. These results suggest the hypothesis that other mechanisms of heating the ICM plasma such as sound waves or cosmic rays may be responsible for observed feedback in galaxy clusters.

Suppression of AGN-driven Turbulence by Magnetic Fields in a Magnetohydrodynamic Model of the Intracluster Medium

NASA Astrophysics Data System (ADS)

Bambic, Christopher J.; Morsony, Brian J.; Reynolds, Christopher S.

2018-04-01

We investigate the role of active galactic nucleus (AGN) feedback in turbulent heating of galaxy clusters. Specifically, we analyze the production of turbulence by g-modes generated by the supersonic expansion and buoyant rise of AGN-driven bubbles. Previous work that neglects magnetic fields has shown that this process is inefficient, with less than 1% of the injected energy ending up in turbulence. This inefficiency primarily arises because the bubbles are shredded apart by hydrodynamic instabilities before they can excite sufficiently strong g-modes. Using a plane-parallel model of the intracluster medium (ICM) and 3D ideal magnetohydrodynamics (MHD) simulations, we examine the role of a large-scale magnetic field that is able to drape around these rising bubbles, preserving them from hydrodynamic instabilities. We find that while magnetic draping appears better able to preserve AGN-driven bubbles, the driving of g-modes and the resulting production of turbulence is still inefficient. The magnetic tension force prevents g-modes from transitioning into the nonlinear regime, suppressing turbulence in our model ICM. Our work highlights the ways in which ideal MHD is an insufficient description for the cluster feedback process, and we discuss future work such as the inclusion of anisotropic viscosity as a means of simulating high β plasma kinetic effects. These results suggest the hypothesis that other mechanisms of heating the ICM plasma such as sound waves or cosmic rays may be responsible for the observed feedback in galaxy clusters.

Mediation of adoption and use: a key strategy for mitigating unintended consequences of health IT implementation

PubMed Central

Anders, Shilo; Gadd, Cynthia S; Lorenzi, Nancy M

2012-01-01

Objective Without careful attention to the work of users, implementation of health IT can produce new risks and inefficiencies in care. This paper uses the technology use mediation framework to examine the work of a group of nurses who serve as mediators of the adoption and use of a barcode medication administration (BCMA) system in an inpatient setting. Materials and methods The study uses ethnographic methods to explore the mediators' work. Data included field notes from observations, documents, and email communications. This variety of sources enabled triangulation of findings between activities observed, discussed in meetings, and reported in emails. Results Mediation work integrated the BCMA tool with nursing practice, anticipating and solving implementation problems. Three themes of mediation work include: resolving challenges related to coordination, integrating the physical aspects of BCMA into everyday practice, and advocacy work. Discussion Previous work suggests the following factors impact mediation effectiveness: proximity to the context of use, understanding of users' practices and norms, credibility with users, and knowledge of the technology and users' technical abilities. We describe three additional factors observed in this case: ‘influence on system developers,’ ‘influence on institutional authorities,’ and ‘understanding the network of organizational relationships that shape the users' work.’ Conclusion Institutionally supported clinicians who facilitate adoption and use of health IT systems can improve the safety and effectiveness of implementation through the management of unintended consequences. Additional research on technology use mediation can advance the science of implementation by providing decision-makers with theoretically durable, empirically grounded evidence for designing implementations. PMID:22634157

Optimised cord blood sample selection for small‑scale CD34+ cell immunomagnetic isolation.

PubMed

Perdomo-Arciniegas, Ana-María; Vernot, Jean-Paul

2012-03-01

Haematopoietic stem cells (HSCs) are defined as multipotential cells, capable of self-renewal and reconstituting in vivo the haematopoietic compartment. The CD34 antigen is considered an important HSCs marker in humans. Immunomagnetic isolation, by targeting CD34 antigen, is widely used for human HSC separation. This method allows the enrichment of human HSCs that are present at low frequencies in umbilical cord blood (CB). Immunomagnetic CD34+-cell isolation reproducibility, regarding cell yield and purity, is affected by the CD34+ cell frequency and total cell numbers present in a given sample; CB HSC purification may thus yield variable results, which also depend on the volume and density fractionation-derived cell loss of a CB sample. The uncertainty of such an outcome and associated technical costs call for a cost-effective sample screening strategy. A correlation analysis using clinical and laboratory data from 59 CB samples was performed to establish predictive variables for CD34+-immunomagnetic HSCs isolation. This study described the positive association of CD34+-cell isolation with white and red cell numbers present after cell fractionation. Furthermore, purity has been correlated with lymphocyte percentages. Predictive variable cut-off values, which are particularly useful in situations involving low CB volumes being collected (such as prevalent late umbilical cord clamping clinical practice), were proposed for HSC isolation sampling. Using the simple and cost-effective CB sample screening criteria described here would lead to avoiding costly inefficient sample purification, thereby ensuring that pure CD34+ cells are obtained in the desired numbers following CD34 immunomagnetic isolation.

Inefficiency in Latin-American market indices

NASA Astrophysics Data System (ADS)

Zunino, L.; Tabak, B. M.; Pérez, D. G.; Garavaglia, M.; Rosso, O. A.

2007-11-01

We explore the deviations from efficiency in the returns and volatility returns of Latin-American market indices. Two different approaches are considered. The dynamics of the Hurst exponent is obtained via a wavelet rolling sample approach, quantifying the degree of long memory exhibited by the stock market indices under analysis. On the other hand, the Tsallis q entropic index is measured in order to take into account the deviations from the Gaussian hypothesis. Different dynamic rankings of inefficieny are obtained, each of them contemplates a different source of inefficiency. Comparing with the results obtained for a developed country (US), we confirm a similar degree of long-range dependence for our emerging markets. Moreover, we show that the inefficiency in the Latin-American countries comes principally from the non-Gaussian form of the probability distributions.

Probing Radiatively Inefficient Accretion Flow in the Neutron Star X-ray Binary System Aquila X-1

NASA Astrophysics Data System (ADS)

Maitra, Dipankar

2016-09-01

The nature of radiatively inefficient accretion flows (RIAF) near neutron stars and black holes remains largely enshrouded in mystery, primarily due to their low luminosity. Long term monitoring of Aql X-1 has revealed that during certain outbursts, the system goes into a relatively bright RIAF state for periods lasting several weeks. These low-intensity states offer a unique opportunity to probe radiatively inefficient flows. We request a 75 ksec Chandra/HETG ToO observation of Aql X-1 during a low-intensity state. Emission line diagnostics of the observed spectrum will be used to test different RIAF models and constrain flow properties such as the radial temperature and density profile, existence of an outflowing wind, spatial extent of the RIAF, and gas dynamics within the flow.

Probing Radiatively Inefficient Accretion Flow in the Neutron Star X-ray Binary System Aquila X-1

NASA Astrophysics Data System (ADS)

Maitra, Dipankar

2017-09-01

The nature of radiatively inefficient accretion flows (RIAF) near neutron stars and black holes remains largely enshrouded in mystery, primarily due to their low luminosity. Long term monitoring of Aql X-1 has revealed that during certain outbursts, the system goes into a relatively bright RIAF state for periods lasting several weeks. These low-intensity states offer a unique opportunity to probe radiatively inefficient flows. We request a 75 ksec Chandra/HETG ToO observation of Aql X-1 during a low-intensity state. Emission line diagnostics of the observed spectrum will be used to test different RIAF models and constrain flow properties such as the radial temperature and density profile, existence of an outflowing wind, spatial extent of the RIAF, and gas dynamics within the flow.

Biomimetic Design of an Under-Actuated Leg Exoskeleton for Load-Carrying Augmentation

DTIC Science & Technology

2006-02-01

exoskeleton design has not considered the passive dynamics of walking and has focused on fully actuated systems that are inefficient and heavy. In this...passive dynamics of walking and has focused on fully actuated systems that are inefficient and heavy. In this thesis, an under-actuated exoskeleton...40 Figure 3.22 Braking torque of the magnetorheological damper vs. current .................... 41 Figure

The Value of Lung Cancer CT Screening: It Is All about Implementation.

PubMed

Goulart, Bernardo H L

2015-01-01

Hospitals have been gradually implementing new lung cancer CT screening programs following the release of the U.S. Preventive Services Task Force grade B recommendation to screen individuals at high risk for lung cancer. Policy makers have legitimately questioned whether adoption of CT screening in the community will reproduce the mortality benefits seen in the National Lung Screening Trial (NLST) and whether the benefits of screening will justify the potentially high costs. Although three annual CT screening exams proved cost-effective for the patient population enrolled in the NLST, uncertainty still exists about whether CT screening will be cost-effective in practice. The value of CT screening will depend largely on the strategies used to implement it. This manuscript reviews the current reimbursement policies for CT screening and explains the relationship between implementation strategies and screening value on the basis of the NLST cost-effectiveness analysis and other published data. A subsequent discussion ensues about the potential implementation inefficiencies that can negatively affect the value of CT screening (e.g., selection of low-risk individuals for screening, inappropriate follow-up visits for screening-detected lung nodules, failure to offer smoking cessation interventions, and overuse of medical resources for clinically irrelevant incidental findings) and the actions that can be taken to mitigate these inefficiencies and increase the value of screening.

Fast Recognition of BCI-Inefficient Users Using Physiological Features from EEG Signals: A Screening Study of Stroke Patients.

PubMed

Shu, Xiaokang; Chen, Shugeng; Yao, Lin; Sheng, Xinjun; Zhang, Dingguo; Jiang, Ning; Jia, Jie; Zhu, Xiangyang

2018-01-01

Motor imagery (MI) based brain-computer interface (BCI) has been developed as an alternative therapy for stroke rehabilitation. However, experimental evidence demonstrates that a significant portion (10-50%) of subjects are BCI-inefficient users (accuracy less than 70%). Thus, predicting BCI performance prior to clinical BCI usage would facilitate the selection of suitable end-users and improve the efficiency of stroke rehabilitation. In the current study, we proposed two physiological variables, i.e., laterality index (LI) and cortical activation strength (CAS), to predict MI-BCI performance. Twenty-four stroke patients and 10 healthy subjects were recruited for this study. Each subject was required to perform two blocks of left- and right-hand MI tasks. Linear regression analyses were performed between the BCI accuracies and two physiological predictors. Here, the predictors were calculated from the electroencephalography (EEG) signals during paretic hand MI tasks (5 trials; approximately 1 min). LI values exhibited a statistically significant correlation with two-class BCI (left vs. right) performance (r = -0.732, p < 0.001), and CAS values exhibited a statistically significant correlation with brain-switch BCI (task vs. idle) performance ( r = 0.641, p < 0.001). Furthermore, the BCI-inefficient users were successfully recognized with a sensitivity of 88.2% and a specificity of 85.7% in the two-class BCI. The brain-switch BCI achieved a sensitivity of 100.0% and a specificity of 87.5% in the discrimination of BCI-inefficient users. These results demonstrated that the proposed BCI predictors were promising to promote the BCI usage in stroke rehabilitation and contribute to a better understanding of the BCI-inefficiency phenomenon in stroke patients.

Fast Recognition of BCI-Inefficient Users Using Physiological Features from EEG Signals: A Screening Study of Stroke Patients

PubMed Central

Shu, Xiaokang; Chen, Shugeng; Yao, Lin; Sheng, Xinjun; Zhang, Dingguo; Jiang, Ning; Jia, Jie; Zhu, Xiangyang

2018-01-01

Motor imagery (MI) based brain-computer interface (BCI) has been developed as an alternative therapy for stroke rehabilitation. However, experimental evidence demonstrates that a significant portion (10–50%) of subjects are BCI-inefficient users (accuracy less than 70%). Thus, predicting BCI performance prior to clinical BCI usage would facilitate the selection of suitable end-users and improve the efficiency of stroke rehabilitation. In the current study, we proposed two physiological variables, i.e., laterality index (LI) and cortical activation strength (CAS), to predict MI-BCI performance. Twenty-four stroke patients and 10 healthy subjects were recruited for this study. Each subject was required to perform two blocks of left- and right-hand MI tasks. Linear regression analyses were performed between the BCI accuracies and two physiological predictors. Here, the predictors were calculated from the electroencephalography (EEG) signals during paretic hand MI tasks (5 trials; approximately 1 min). LI values exhibited a statistically significant correlation with two-class BCI (left vs. right) performance (r = −0.732, p < 0.001), and CAS values exhibited a statistically significant correlation with brain-switch BCI (task vs. idle) performance (r = 0.641, p < 0.001). Furthermore, the BCI-inefficient users were successfully recognized with a sensitivity of 88.2% and a specificity of 85.7% in the two-class BCI. The brain-switch BCI achieved a sensitivity of 100.0% and a specificity of 87.5% in the discrimination of BCI-inefficient users. These results demonstrated that the proposed BCI predictors were promising to promote the BCI usage in stroke rehabilitation and contribute to a better understanding of the BCI-inefficiency phenomenon in stroke patients. PMID:29515363

DOD Financial Management: Improvements Needed in Army’s Efforts to Ensure the Reliability of Its Statement of Budgetary Resources

DTIC Science & Technology

2014-05-01

a cost- effective approach for achieving audit readiness. To help minimize the inefficient use of resources when previously identified deficiencies...System (GFEBS) emphasizing the implementation of effective business processes. However, the Army did not fully complete certain tasks in accordance...represent material portions of future SBRs and, if not auditable, will likely affect the Army’s ability to achieve audit readiness goals as planned

Economic efficiency in fish farming: hope for agro-allied industries in Niagara

NASA Astrophysics Data System (ADS)

Kareem, R. O.; Dipeolu, A. O.; Aromolaran, A. B.; Williams, S. B.

2008-02-01

The challenge to increase the efficiency in food production level in Nigeria appears to be more urgent now than it has ever been in the history of the country. This is in view of the rapidly increasing population, the imminent decline in international economic and food aid and the need to conserve foreign exchange earnings through the production of raw materials to feed the growing industrial sector calls for urgent attention. The study was carried out in Ogun State. The descriptive statistics was used to determine the socio-economic characteristics of the respondents. The stochastic frontiers production analysis was applied to estimate the technical, allocative efficiency and economic efficiency among the fish farmers in the state. The results of economic efficiency revealed that fish farming is economically efficient with a range of between 55% and 84% efficiency level suggesting a favourable hope for the agro-allied industry such as poultry and cottage industries etc in the state. The result of hypothesis of inefficiency sources models showed that years of experience of fish farmers is significant at 1% probability level indicating the factor contributing to the fish farming experience in the state. Thus, the efficiency is due to the fact that farmers are experienced and fairly educated. On the basis of findings, policy is suggested to be directed towards the encouragement of entrepreneurs in fish farming in the state by providing enabling environment like credit facilities, public enlightenment programme and provision of social amenities like feeder roads, pipe-born water etc and given the fact that an increase in the level of formal education variable leads to less inefficiency, government policy should be focused on adopting the best technology (e.g. fast growing species and equipment) so as to improve the level of efficiency and investment which shall eventually lead to growth in output of fish farming and a lead to the establishment of agro-allied industries in the state.

A Novel Method of Evaluating Key Factors for Success in a Multifaceted Critical Care Fellowship Using Data Envelopment Analysis.

PubMed

Tiwari, Vikram; Kumar, Avinash B

2018-01-01

The current system of summative multi-rater evaluations and standardized tests to determine readiness to graduate from critical care fellowships has limitations. We sought to pilot the use of data envelopment analysis (DEA) to assess what aspects of the fellowship program contribute the most to an individual fellow's success. DEA is a nonparametric, operations research technique that uses linear programming to determine the technical efficiency of an entity based on its relative usage of resources in producing the outcome. Retrospective cohort study. Critical care fellows (n = 15) in an Accreditation Council for Graduate Medical Education (ACGME) accredited fellowship at a major academic medical center in the United States. After obtaining institutional review board approval for this retrospective study, we analyzed the data of 15 anesthesiology critical care fellows from academic years 2013-2015. The input-oriented DEA model develops a composite score for each fellow based on multiple inputs and outputs. The inputs included the didactic sessions attended, the ratio of clinical duty works hours to the procedures performed (work intensity index), and the outputs were the Multidisciplinary Critical Care Knowledge Assessment Program (MCCKAP) score and summative evaluations of fellows. A DEA efficiency score that ranged from 0 to 1 was generated for each of the fellows. Five fellows were rated as DEA efficient, and 10 fellows were characterized in the DEA inefficient group. The model was able to forecast the level of effort needed for each inefficient fellow, to achieve similar outputs as their best performing peers. The model also identified the work intensity index as the key element that characterized the best performers in our fellowship. DEA is a feasible method of objectively evaluating peer performance in a critical care fellowship beyond summative evaluations alone and can potentially be a powerful tool to guide individual performance during the fellowship.

Combining inferences from models of capture efficiency, detectability, and suitable habitat to classify landscapes for conservation of threatened bull trout

Treesearch

James T. Peterson; Jason Dunham

2003-01-01

Effective conservation efforts for at-risk species require knowledge of the locations of existing populations. Species presence can be estimated directly by conducting field-sampling surveys or alternatively by developing predictive models. Direct surveys can be expensive and inefficient, particularly for rare and difficult- to-sample species, and models of species...

Effect of sole or combined administration of nitrate and 3-nitro-1-propionic acid on fermentation and Salmonella survivability in alfalfa-fed rumen cultures in vitro

USDA-ARS?s Scientific Manuscript database

Ruminal methanogenesis is a digestive inefficiency resulting in the loss of dietary energy consumed by the host and contributing to environmental methane emission. Nitrate is being investigated as a feed supplement to reduce rumen methane emissions, but safety and efficacy concerns persist. To ass...

Postmodeling Sensitivity Analysis to Detect the Effect of Missing Data Mechanisms

ERIC Educational Resources Information Center

Jamshidian, Mortaza; Mata, Matthew

2008-01-01

Incomplete or missing data is a common problem in almost all areas of empirical research. It is well known that simple and ad hoc methods such as complete case analysis or mean imputation can lead to biased and/or inefficient estimates. The method of maximum likelihood works well; however, when the missing data mechanism is not one of missing…

The Impact of Managerialism on the Strategy Work of University Middle Managers

ERIC Educational Resources Information Center

Davis, Annemarie; Jansen van Rensburg, Mari; Venter, Peet

2016-01-01

In an attempt to understand the effects of managerialism on university managers in a developing country, we set out to gather rich data on the strategy work of middle managers through a single case study at a South African university. Managerialism has the potential to solve inefficiencies in university systems and processes, as it could help to…

Responsibility Factors of Reducing Inefficiencies in Information System Processes and Their Role on Intention to Acquire Six Sigma Certification

ERIC Educational Resources Information Center

Hejazi, Sara

2009-01-01

Organizations worldwide have been turning to Six Sigma program (SSP) to eliminate the defects in their products or drive out the variability in their processes to attain a competitive advantage in their marketplace. An effective certification program has been touted as a major contributor to successful implementation of SSP. An effective…

Strengthening revenue cycle capabilities in an era of reform.

PubMed

Glaser, John

2011-05-01

Strategies that healthcare finance professionals should incorporate to help their organizations respond effectively to payment reforms include: Assessing the organization's ability to capture and share relevant data. Educating themselves, the board of trustees, and the medical staff on pertinent rules as payment reforms are rolled out. Examining inefficiencies related to care processes. Establishing policies and procedures to address "commingled" data.

Transnational Criminal Organizations: Mexico’s Commercial Insurgency

DTIC Science & Technology

2012-10-01

government officials and journalists have compared the violence of transnational criminal organizations (TCOs) within Mexico to the terrorist tactics...inefficient allocation of diplomatic, military, and economic power. Latency on the part of government officials and military strategists further complicates...matters. When evaluating a potential adversary, govern - ments often respond too late to be effective in crises. For example, in 1994, 800,000

Tracking and Treating Mobile Populations. The TB Net System. Migrant Clinicians Network Monograph Series. = El Sistema de Red para la TB.

ERIC Educational Resources Information Center

Migrant Clinicians Network, Inc., Austin, TX.

A comprehensive tracking and referral network that helps provide continuity of care for mobile populations with active tuberculosis (TB) or TB infection is considered essential for effective treatment of TB. However, the interstate referral system that exists between state health departments has been highly inefficient for serving migrant…

[Drug utilization and pharmaceutical cost-containment in germany-perspectives 1 year after enactment of the GMG].

PubMed

Schlander, Michael

2005-06-15

After 3 decades of health care cost containment in Germany, enactment of the most recent reform (Health Insurance Modernization Act, GMG) marks a watershed insofar as, apparently, the potential has been largely exhausted for further savings in pharmaceutical spending. Yet the new drugs segment maintains its role as a growth driver, owing to the continuing shift from older to new, and frequently more expensive, products. This observation holds true even after introducing phase 2 reference pricing, covering so-called me too products. Health economic analyses would be required to better differentiate pharmaceutical products based on their incremental cost-effectiveness ratio. However, the opportunity was missed with the GMG to introduce formal health-economic evaluations and thus overcome the counterproductive silo mentality associated with traditional German component management. International experience from Australia, Canada, and the United Kingdom suggests that economic evaluations, while informing rational reimbursement decisions, may in fact contribute to increasing pharmaceutical expenditures. Further tightening of pharmaceutical component management in Germany may result in increasing inefficiencies due to underuse of effective products; furthermore, it appears conceivable that ("second order") dynamic inefficiencies and, hence, social costs might be the consequence of reduced pharmaceutical research and development expenditures.

Effect of porous structure of catalyst layer on effective oxygen diffusion coefficient in polymer electrolyte fuel cell

NASA Astrophysics Data System (ADS)

Inoue, Gen; Kawase, Motoaki

2016-09-01

It is important to reduce the oxygen diffusion resistance through PEFC porous electrode, because it is the key to reduce the PEFC cost. However, the gas diffusion coefficient of CL is lower than MPL in spite of framework consisted of same carbon blacks. In this study, in order to understand the reasons of the lower gas diffusion performance of CL, the relationship between a carbon black agglomerate structure and ionomer adhesion condition is evaluated by a numerical analysis with an actual reconstructed structure and a simulated structure. As a result, the gas diffusion property of CL strongly depends on the ionomer adhesion shape. In the case of adhesion shape with the same curvature of ionomer interface, each pore can not be connected enough. So the pore tortuosity increases. Moreover, in the case of existence of inefficient large pores formed by carbon black agglomerate and ununiformly coated ionomer, the gas diffusion performance decrease rapidly. As the measurement values in actual CL are almost equal to that with model structure with inefficient large pores. These characteristics can be confirmed by actual cross-section image obtained by FIB-SEM.

Inhibition of nitrogenase by oxygen in marine cyanobacteria controls the global nitrogen and oxygen cycles

NASA Astrophysics Data System (ADS)

Berman-Frank, I.; Chen, Y.-B.; Gerchman, Y.; Dismukes, G. C.; Falkowski, P. G.

2005-03-01

Cyanobacterial N2-fixation supplies the vast majority of biologically accessible inorganic nitrogen to nutrient-poor aquatic ecosystems. The process, catalyzed by the heterodimeric protein complex, nitrogenase, is thought to predate that of oxygenic photosynthesis. Remarkably, while the enzyme plays such a critical role in Earth's biogeochemical cycles, the activity of nitrogenase in cyanobacteria is markedly inhibited in vivo at a post-translational level by the concentration of O2 in the contemporary atmosphere leading to metabolic and biogeochemical inefficiency in N2 fixation. We illustrate this crippling effect with data from Trichodesmium spp. an important contributor of "new nitrogen" to the world's subtropical and tropical oceans. The enzymatic inefficiency of nitrogenase imposes a major elemental taxation on diazotrophic cyanobacteria both in the costs of protein synthesis and for scarce trace elements, such as iron. This restriction has, in turn, led to a global limitation of fixed nitrogen in the contemporary oceans and provides a strong biological control on the upper bound of oxygen concentration in Earth's atmosphere.

Industry Efficiency and Total Factor Productivity Growth under Resources and Environmental Constraint in China

PubMed Central

Tao, Feng; Li, Ling; Xia, X. H.

2012-01-01

The growth of China's industry has been seriously depending on energy and environment. This paper attempts to apply the directional distance function and the Luenberger productivity index to measure the environmental efficiency, environmental total factor productivity, and its components at the level of subindustry in China over the period from 1999 to 2009 while considering energy consumption and emission of pollutants. This paper also empirically examines the determinants of efficiency and productivity change. The major findings are as follows. Firstly, the main sources of environmental inefficiency of China's industry are the inefficiency of gross industrial output value, the excessive energy consumption, and pollutant emissions. Secondly, the highest growth rate of environmental total factor productivity among the three industrial categories is manufacturing, followed by mining, and production and supply of electricity, gas, and water. Thirdly, foreign direct investment, capital-labor ratio, ownership structure, energy consumption structure, and environmental regulation have varying degrees of effects on the environmental efficiency and environmental total factor productivity. PMID:23365517

Industry efficiency and total factor productivity growth under resources and environmental constraint in China.

PubMed

Tao, Feng; Li, Ling; Xia, X H

2012-01-01

The growth of China's industry has been seriously depending on energy and environment. This paper attempts to apply the directional distance function and the Luenberger productivity index to measure the environmental efficiency, environmental total factor productivity, and its components at the level of subindustry in China over the period from 1999 to 2009 while considering energy consumption and emission of pollutants. This paper also empirically examines the determinants of efficiency and productivity change. The major findings are as follows. Firstly, the main sources of environmental inefficiency of China's industry are the inefficiency of gross industrial output value, the excessive energy consumption, and pollutant emissions. Secondly, the highest growth rate of environmental total factor productivity among the three industrial categories is manufacturing, followed by mining, and production and supply of electricity, gas, and water. Thirdly, foreign direct investment, capital-labor ratio, ownership structure, energy consumption structure, and environmental regulation have varying degrees of effects on the environmental efficiency and environmental total factor productivity.

Stewardship to tackle global phosphorus inefficiency: The case of Europe.

PubMed

Withers, Paul J A; van Dijk, Kimo C; Neset, Tina-Simone S; Nesme, Thomas; Oenema, Oene; Rubæk, Gitte H; Schoumans, Oscar F; Smit, Bert; Pellerin, Sylvain

2015-03-01

The inefficient use of phosphorus (P) in the food chain is a threat to the global aquatic environment and the health and well-being of citizens, and it is depleting an essential finite natural resource critical for future food security and ecosystem function. We outline a strategic framework of 5R stewardship (Re-align P inputs, Reduce P losses, Recycle P in bioresources, Recover P in wastes, and Redefine P in food systems) to help identify and deliver a range of integrated, cost-effective, and feasible technological innovations to improve P use efficiency in society and reduce Europe's dependence on P imports. Their combined adoption facilitated by interactive policies, co-operation between upstream and downstream stakeholders (researchers, investors, producers, distributors, and consumers), and more harmonized approaches to P accounting would maximize the resource and environmental benefits and help deliver a more competitive, circular, and sustainable European economy. The case of Europe provides a blueprint for global P stewardship.

Audit Report on "Work for Others Performed by the Department of Energy for the Department of Defense"

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

Pursuant to the Atomic Energy Act of 1954, as amended, and the Economy Act of 1932, the Department of Energy and its semi-autonomous National Nuclear Security Administration (NNSA) provide research and technical assistance to other Federal agencies on a reimbursable, full cost recovery basis through the Work for Others (WFO) program. For the vast majority of WFO technical projects, Department Federal officials furnish administrative project oversight while the actual detailed scientific or technical work is completed by the Department's 'management and operating' contractors. These contractors are awarded a special contract type specifically created under the Federal Acquisition Regulation to managemore » and operate Department sites and facilities, including sophisticated laboratories and technical centers, on a government-owned, contractor-operated basis. With annual expenditures exceeding $1 billion, the Department of Defense (DoD) is one of the Department's largest WFO customers. Work performed for DoD at the Department's national laboratories and other facilities includes highly technical research in areas such as nuclear weapons systems, counter-terrorism, and in-theater troop support. The National Defense Authorization Act for Fiscal Year (FY) 2009, required the Inspectors General of the DoD and the Department to review procurement methods to determine whether the Department complied with DoD procurement requirements and/or whether alternative procurement policies were in place. In response, we focused our review on projects performed by NNSA because it completes the vast majority (approximately $900 million in FY 2008) of the Department's work for DoD. As part of this effort, and, at the specific request of the DoD Office of Inspector General (DoD OIG), we identified the universe of WFO technical projects that received new funding in the fourth quarter of FY 2008 at NNSA sites. We independently reviewed a judgmental sample of 11 projects selected by the DoD OIG to meet the objectives of this audit. Our review revealed that NNSA managed DoD WFO technical projects in a manner consistent with requirements of the Atomic Energy Act of 1954, the Federal Acquisition Regulation, and the Department's implementing guidance, the Department of Energy Acquisition Regulation. Because of the very nature of the Department's management and operating contracting model, WFO projects may not be technically compliant with DoD procurement regulations in certain instances. We found that NNSA did not let new contracts or task orders for the DoD WFO technical projects we reviewed and instead managed them under its existing internal control process as part of its management and operating contract structure. In one instance, we noted that the Department had, at DoD's request, supplemented its control structure to incorporate specific DoD procurement requirements. Senior Department of Energy procurement officials acknowledged that neither the Department nor NNSA modified their existing prime contracts to incorporate specific defense procurement requirements because such modifications would be inappropriate, costly, and inefficient. In short, they informed us that the Department had developed and implemented a series of controls designed to monitor overall contractor performance, including WFO technical projects. Department and NNSA officials noted, however, that they were willing to incorporate DoD specific requirements into work orders should DoD request and fund such efforts. Additional details regarding management of WFO technical projects are discussed in the body of this report.« less

Parkinson's Law quantified: three investigations on bureaucratic inefficiency

NASA Astrophysics Data System (ADS)

Klimek, Peter; Hanel, Rudolf; Thurner, Stefan

2009-03-01

We formulate three famous, descriptive essays of Parkinson on bureaucratic inefficiency in a quantifiable and dynamical socio-physical framework. In the first model we show how the use of recent opinion formation models for small groups can be used to understand Parkinson's observation that decision-making bodies such as cabinets or boards become highly inefficient once their size exceeds a critical 'Coefficient of Inefficiency', typically around 20. A second observation of Parkinson—which is sometimes referred to as Parkinson's Law—is that the growth of bureaucratic or administrative bodies usually goes hand in hand with a drastic decrease of its overall efficiency. In our second model we view a bureaucratic body as a system of a flow of workers, who enter, become promoted to various internal levels within the system over time, and leave the system after having served for a certain time. Promotion usually is associated with an increase of subordinates. Within the proposed model it becomes possible to work out the phase diagram under which conditions of bureaucratic growth can be confined. In our last model we assign individual efficiency curves to workers throughout their life in administration, and compute the optimum time to give them the old age pension, in order to ensure a maximum of efficiency within the body—in Parkinson's words we compute the 'Pension Point'.

Randomized controlled trial of a dose consolidation program.

PubMed

Delate, Thomas; Fairman, Kathleen A; Carey, Shelly M; Motheral, Brenda R

2004-01-01

To evaluate the effectiveness and financial impact of a drug dose consolidation (optimization) program using letter intervention. This pilot program in a large, mid-Atlantic health plan utilized a randomized controlled trial research design. A review of adjudicated pharmacy claims records was performed monthly for 3 consecutive months from November 2002 through February 2003 to identify inefficient (i.e., >once-daily) regimens for any one of 68 dosage strengths of 37 single-source maintenance drugs with once-daily dosing recommendations. Prescribers who had prescribed one or more inefficient regimens were identified and randomized to one of the 2 intervention arms or a control arm. Prescribers in both intervention arms were sent personalized letters with information on their patients. inefficient regimens and suggested dose consolidation options. Patients of prescribers in one intervention arm received a complementary, patient-oriented letter. Pharmacy claims for patients in all arms were examined at 180 days after the date of the letter mailing for conversion to an efficient (once-daily) regimen. Financial modeling analysis calculated net savings as changes in pharmacy expenditures minus administrative costs. A total of 2,614 inefficient regimens, representing 6.7% of claims for the targeted medications, were identified. The rate of consolidation to a suggested dosing option was lower for the Physician Letter arm (7.3%) than for the Physician/Member Letter arm (10.2%) (P = 0.046). Both intervention arms had higher consolidation rates than the Control arm (3.9%) (P = 0.018 and P = 0.000, respectively.). Approximately 30% of the regimens in each study arm were never refilled after being targeted. Financial modeling indicated that a dose consolidation intervention could save 0.03 dollars to 0.07 dollars per member per month (PMPM) in 2003 dollars with full medication compliance but only 0.02 dollars to 0.03 dollars PMPM when savings were calculated with realistic, partial compliance rates. Subanalyses performed at the drug therapy class level revealed few opportunities to justify implementing a dose consolidation program. After taking into consideration program administrative costs, high rates of refill discontinuation, and dose consolidation that occurs naturally without intervention, the results indicated that a letter-based dose consolidation program did not appreciably decrease pharmacy expenditures.

Seeking consensus for cyberinfrastructure governance in the USA

NASA Astrophysics Data System (ADS)

Allison, M. Lee; Zanzkerkia, Eva

2014-05-01

Governance of geosciences cyberinfrastructure is a complex and essential undertaking, critical in enabling distributed knowledge communities to collaborate and communicate across disciplines, distances, and cultures. Advancing science with respect to "grand challenges," such as global change, Earth system observation, modeling, and prediction, and core fundamental science, depends not just on technical cyber systems, but also on social systems for strategic planning, decision-making, project management, learning, teaching, and building a community of practice. Simply put, a robust, agile technical system depends on an equally robust and adaptable social system. Cyberinfrastructure development is wrapped in social, organizational and governance challenges which may significantly impede technical progress and result in inefficiencies, duplication of effort, incompatibilities, wasted resources or user frustration. These issues are also the most time consuming to resolve due to significant institutional and social inertia: hence the urgency for developing a governance blueprint. An agile development process is underway for governance of transformative investments in geosciences cyberinfrastructure through the US National Science Foundation's EarthCube Program. Agile development is iterative and incremental, and promotes adaptive planning and rapid and flexible response. Such iterative deployment across a variety of EarthCube stakeholders encourages transparency, consensus, accountability, and inclusiveness. A broad coalition of stakeholder groups comprises an Assembly to serve as a preliminary venue for identifying, evaluating, and testing potential governance models. To offer opportunity for ensure broader end-user input and buy-in, a crowd-source approach engages stakeholders not involved otherwise in the Assembly. Developmental evaluators from the social sciences embedded in the project will provide real-time review and adjustments. In order to ensure an open and inclusive process, community-selected leaders play key roles through an Assembly Advisory Council. If consensus is reached on a governing framework, a community-selected demonstration governance demonstration pilot will help facilitate community convergence on system design.

Signal coupling to embedded pitch adapters in silicon sensors

NASA Astrophysics Data System (ADS)

Artuso, M.; Betancourt, C.; Bezshyiko, I.; Blusk, S.; Bruendler, R.; Bugiel, S.; Dasgupta, R.; Dendek, A.; Dey, B.; Ely, S.; Lionetto, F.; Petruzzo, M.; Polyakov, I.; Rudolph, M.; Schindler, H.; Steinkamp, O.; Stone, S.

2018-01-01

We have examined the effects of embedded pitch adapters on signal formation in n-substrate silicon microstrip sensors with data from beam tests and simulation. According to simulation, the presence of the pitch adapter metal layer changes the electric field inside the sensor, resulting in slowed signal formation on the nearby strips and a pick-up effect on the pitch adapter. This can result in an inefficiency to detect particles passing through the pitch adapter region. All these effects have been observed in the beam test data.

Star formation in proto dwarf galaxies

NASA Technical Reports Server (NTRS)

Noriega-Crespo, A.; Bodenheimer, P.; Lin, D. N. C.; Tenorio-Tagle, G.

1990-01-01

The effects of the onset of star formation on the residual gas in primordial low-mass Local-Group dwarf spheroidal galaxies is studied by a series of hydrodynamical simulations. The models have concentrated on the effect of photoionization. The results indicate that photoionization in the presence of a moderate gas density gradient can eject most of the residual gas on a time scale of a few 10 to the 7th power years. High central gas density combined with inefficient star formation, however, may prevent mass ejection. The effect of supernova explosions is discussed briefly.

Perspectives on lantibiotic discovery - where have we failed and what improvements are required?

PubMed

Sandiford, Stephanie Kate

2015-04-01

The increasing resistance of bacteria to conventional antimicrobial therapy within both the nosocomial and community environment has enforced the urgent requirement for the discovery of novel agents. This has stimulated increased research efforts within the field of lantibiotic discovery. Lantibiotics are ribosomally synthesised, post-translationally modified antimicrobial peptides that exhibit antimicrobial activity against a range of multi-drug-resistant (MDR) bacteria. The success of these agents as a novel treatment of MDR infections is exemplified by: the clinical development of MU1140 (mutacin 1140) and NAI-107 (microbisporicin), which are in late pre-clinical trials against gram-positive bacteria; NVB302 that has completed Phase I clinical trials for the treatment of Clostridium difficile infections and; duramycin that has completed Phase II clinical trials in the treatment of cystic fibrosis. Despite these potential successes, the traditional method of lantibiotic discovery involving the induction, production and identification is often an inefficient, time-consuming process creating a barrier to the efficient discovery of novel lantibiotics. The introduction of novel and innovative identification methods, including the application of probes and the ability to improve the stability and activity of agents via mutagenesis offer encouraging new areas to explore. The rapid expansion of available genome sequences of a wide variety of bacteria has revealed multiple interesting lantibiotic clusters that have the potential to be effective antimicrobials. However, due to the inefficient expression, screening and production methods currently employed, they are being assessed inefficiently and not rapidly enough to keep up with the ever-increasing demand for new agents.

Young Adults at Risk for Stimulant Dependence show Reward Dysfunction during Reinforcement-Based Decision Making

PubMed Central

Stewart, Jennifer L.; Flagan, Taru M.; May, April C.; Reske, Martina; Simmons, Alan N.; Paulus, Martin P.

2012-01-01

Background While stimulant dependent individuals continue to make risky decisions in spite of poor outcomes, much less is known about decision-making characteristics of occasional stimulant users (OSU) at risk for developing stimulant dependence. This study examines whether OSU exhibit inefficient learning and execution of reinforced decision-outcome contingencies. Methods OSU (n=161) and stimulant-naïve comparison subjects (CTL; n=48) performed a Paper Scissors Rock task during functional magnetic resonance imaging. Selecting a particular option was associated with a pre-determined probability of winning, which was altered repeatedly to examine neural and behavioral characteristics of reinforced contingencies. Results OSU displayed greater anterior insula, inferior frontal gyrus (IFG), and dorsal striatum activation than CTL during late trials when contingencies were familiar (as opposed to being learned) in the presence of comparable behavioral performance in both groups. Follow-up analyses demonstrated that during late trials: (1) OSU with high cannabis use displayed greater activation in these brain regions than CTL, whereas OSU with low cannabis use did not differ from the other two groups; and (2) OSU preferring cocaine exhibited greater anterior insula, IFG, and dorsal striatum activation than CTL and also displayed higher activation in the former two regions than OSU who preferred prescription stimulants. Conclusions OSU exhibit inefficient resource allocation during the execution of reinforced contingencies that may be a result of additive effects of cocaine and cannabis use. A critical next step is to establish whether this inefficiency predicts transition to stimulant dependence. PMID:23021534

Inefficient epidemic spreading in scale-free networks

NASA Astrophysics Data System (ADS)

Piccardi, Carlo; Casagrandi, Renato

2008-02-01

Highly heterogeneous degree distributions yield efficient spreading of simple epidemics through networks, but can be inefficient with more complex epidemiological processes. We study diseases with nonlinear force of infection whose prevalences can abruptly collapse to zero while decreasing the transmission parameters. We find that scale-free networks can be unable to support diseases that, on the contrary, are able to persist at high endemic levels in homogeneous networks with the same average degree.

Information-Velocity Metric for the Flow of Information through an Organization: Application to Decision Support

DTIC Science & Technology

2009-06-17

pyramid. Hh represents the amount of human-to- human communication that limits v(info). Hh represents a traditional but inefficient, unscalable, and...Equa- tion (20) weights evenly improved efficiency of sharing information (by moving away from tradi- tional human-to- human communication methods and...the right time. The second line of equation (20) implies that human-to- human communication methods are inefficient and unscalable. For example, an

Feasibility Study For A Spaceborne Ozone/Aerosol Lidar System

NASA Technical Reports Server (NTRS)

Campbell, Richard E.; Browell, Edward V.; Ismail, Syed; Dudelzak, Alexander E.; Carswell, Allan I.; Ulitsky, Arkady

1997-01-01

Because ozone provides a shield against harmful ultraviolet radiation, determines the temperature profile in the stratosphere, plays important roles in tropospheric chemistry and climate, and is a health risk near the surface, changes in natural ozone layers at different altitudes and their global impact are being intensively researched. Global ozone coverage is currently provided by passive optical and microwave satellite sensors that cannot deliver high spatial resolution measurements and have particular limitations in the troposphere. Vertical profiling DIfferential Absorption Lidars (DIAL) have shown excellent range-resolved capabilities, but these systems have been large, inefficient, and have required continuous technical attention for long term operations. Recently, successful, autonomous DIAL measurements have been performed from a high-altitude aircraft (LASE - Lidar Atmospheric Sensing Experiment), and a space-qualified aerosol lidar system (LITE - Laser In-space Technology Experiment) has performed well on Shuttle. Based on the above successes, NASA and the Canadian Space Agency are jointly studying the feasibility of developing ORACLE (Ozone Research with Advanced Cooperative Lidar Experiments), an autonomously operated, compact DIAL instrument to be placed in orbit using a Pegasus class launch vehicle.

Innovative Equipment and Production Method for Mixed Fodder in the Conditions of Agricultural Enterprises

NASA Astrophysics Data System (ADS)

Sabiev, U. K.; Demchuk, E. V.; Myalo, V. V.; Soyunov, A. S.

2017-07-01

It is recommended to feed the cattle and poultry with grain fodder in the form of feed mixture balanced according to the content. Feeding of grain fodder in the form of stock feed is inefficient and economically unreasonable. The article is devoted to actual problem - the preparation of mixed fodder in the conditions of agricultural enterprises. Review and critical analyses of mixed fodder assemblies and aggregates are given. Structural and technical schemes of small-size mixed fodder aggregate with intensified attachments of vibrating and percussive action for preparation of bulk feed mixture in the conditions of agricultural enterprises were developed. The mixed fodder aggregate for its preparation in the places of direct consumption from own grain fodder production and purchased protein and vitamin supplements is also suggested. Mixed fodder aggregate allows to get prepared mixed fodder of high uniformity at low cost of energy and price of production that is becoming profitable for livestock breeding. Model line-up of suggested mixed fodder aggregate with different productivity both for small and big agricultural enterprises is considered.

Preconditions for market solution to urban water scarcity: Empirical results from Hyderabad City, India

NASA Astrophysics Data System (ADS)

Saleth, R. Maria; Dinar, Ariel

2001-01-01

Utilizing both primary and secondary information pertaining to the water sector of Hyderabad City, India, this paper (1) evaluates the economics of various technically feasible supply augmentations options; (2) estimates the group-specific water demand and consumption response functions under alternative pricing behaviors; (3) calculates the net willingness to pay (NWTP, considered to be the value of raw water at source) of different user groups as derived from their respective price elasticities; (4) shows how inadequate the NWTP is to justify most supply augmentation options including intersectoral water transfers under the existing water rate structure; (5) argues that the economic and institutional conditions internal to urban water sector cannot justify an externally imposed water transfers, whether market-based or otherwise, as long as the water rate structure is inefficient and regressive; and (6) concludes by underlining the central role that the pricing option, both the level and structure, plays not only in activating a number of nonprice options but also in generating incentives for the emergence of new and the consolidation of existing institutional conditions needed to support economically rooted water transfers and conservation initiatives.

Assessing exposures to household air pollution in public health research and program evaluation.

PubMed

Northcross, Amanda L; Hwang, Nina; Balakrishnan, Kalpana; Mehta, Sumi

2015-03-01

Exposure to smoke from the use of solid fuels and inefficient stoves for cooking and heating is responsible for approximately 4 million premature deaths yearly. As increasing investments are made to tackle this important public health issue, there is a need for identifying and providing guidance on best practices for exposure and stove performance monitoring, particularly for public health research and evaluation studies. This paper, which builds upon the discussion at an expert consultation on exposure assessment convened by the Global Alliance for Clean Cookstoves, the Centers for Disease Control and Prevention, and PATH in late 2012, aims to provide general guidance on what to monitor, who and where to monitor, and how to monitor household air pollution exposures. In addition, we summarize information about commercially available monitoring equipment and the technical properties of these monitors most important for household air pollution exposure assessment. The target audience includes epidemiologists conducting health studies and program evaluators aiming to quantify changes in exposures to estimate the potential health benefits of cookstoves intervention projects.

Health insurance in Croatia: dynamics and politics of balancing revenues and expenditures.

PubMed

Voncina, Luka; Kehler, Jenni; Evetovits, Tamas; Bagat, Mario

2010-04-01

Since 2002, the Croatian social health insurance system has undergone substantial reforms, initiated for the most part with the aim of addressing the perpetual financial deficits of the state health insurance fund. While the reforms focussed heavily on increasing the inflow of private funds into the health care system, underlying inefficiencies contributing significantly to poor financial performance have been largely ignored. Furthermore, contrary to demographic trends and developments in social health insurance schemes in other countries, funding health care became even more dependent on its main collection mechanism-payroll tax-and consequently on the employment ratio and wage level. Little effort has been made to diversify the revenue base or to increase the efficiency of revenue collection. Like other countries, Croatia is facing difficulties in adjusting its 'Bismarck' system to its changing demographic and socioeconomic context. Instead of targetting a comprehensive effort at improving revenue collection and limitating unnecessary expenditure and system inefficiencies, simplified approaches to balance the budget have been implemented at a high price to users and with limited effect. As a result, the Croatian health insurance system now offers a lower level of financial protection, while still facing the problem of spending more than can be collected through the current mix of revenue collection mechanisms. The authors suggest that, in order to meet the sustainability requirement of the health financing system, measures affecting both revenue and expenditure should be considered and implemented. On the revenue collection side, the Croatian government must make further efforts to improve collection from the informally employed to broaden the base of contributing members; equally important is the diversification of revenue sources by increasing transfers from general taxation revenues. On the expenditure side, exploring inefficiencies of the delivery system can be delayed no longer, and the introduction of effective cost-control mechanisms and financial discipline would seem to be unavoidable.

Application of microfluidic technologies to human assisted reproduction

PubMed Central

Takayama, Shuichi

2017-01-01

Abstract Microfluidics can be considered both a science and a technology. It is defined as the study of fluid behavior at a sub-microliter level and the investigation into its application to cell biology, chemistry, genetics, molecular biology and medicine. There are at least two characteristics of microfluidics, mechanical and biochemical, which can be influential in the field of mammalian gamete and preimplantation embryo biology. These microfluidic characteristics can assist in basic biological studies on sperm, oocyte and preimplantation embryo structure, function and environment. The mechanical and biochemical characteristics of microfluidics may also have practical and/or technical application(s) to assisted reproductive technologies (ART) in rodents, domestic species, endangered species and humans. This review will consider data in mammals, and when available humans, addressing the potential application(s) of microfluidics to assisted reproduction. There are numerous sequential steps in the clinical assisted reproductive laboratory process that work, yet could be improved. Cause and effect relations of procedural inefficiencies can be difficult to identify and/or remedy. Data will be presented that consider microfluidic applications to sperm isolation, oocyte cumulus complex isolation, oocyte denuding, oocyte mechanical manipulation, conventional insemination, intracytoplasmic sperm injection, embryo culture, embryo analysis and oocyte and embryo cryopreservation. While these studies have progressed in animal models, data with human gametes and embryos are significantly lacking. These data from clinical trials are requisite for making future evidence-based decisions regarding the application of microfluidics in human ART. PMID:28130394

Three-dimensional ultrasound imaging of the prostate

NASA Astrophysics Data System (ADS)

Fenster, Aaron; Downey, Donal B.

1999-05-01

Ultrasonography, a widely used imaging modality for the diagnosis and staging of many diseases, is an important cost- effective technique, however, technical improvements are necessary to realize its full potential. Two-dimensional viewing of 3D anatomy, using conventional ultrasonography, limits our ability to quantify and visualize most diseases, causing, in part, the reported variability in diagnosis and ultrasound guided therapy and surgery. This occurs because conventional ultrasound images are 2D, yet the anatomy is 3D; hence the diagnostician must integrate multiple images in his mind. This practice is inefficient, and may lead to operator variability and incorrect diagnoses. In addition, the 2D ultrasound image represents a single thin plane at some arbitrary angle in the body. It is difficult to localize and reproduce the image plane subsequently, making conventional ultrasonography unsatisfactory for follow-up studies and for monitoring therapy. Our efforts have focused on overcoming these deficiencies by developing 3D ultrasound imaging techniques that can acquire B-mode, color Doppler and power Doppler images. An inexpensive desktop computer is used to reconstruct the information in 3D, and then is also used for interactive viewing of the 3D images. We have used 3D ultrasound images for the diagnosis of prostate cancer, carotid disease, breast cancer and liver disease and for applications in obstetrics and gynecology. In addition, we have also used 3D ultrasonography for image-guided minimally invasive therapeutic applications of the prostate such as cryotherapy and brachytherapy.

Automated grading of lumbar disc degeneration via supervised distance metric learning

NASA Astrophysics Data System (ADS)

He, Xiaoxu; Landis, Mark; Leung, Stephanie; Warrington, James; Shmuilovich, Olga; Li, Shuo

2017-03-01

Lumbar disc degeneration (LDD) is a commonly age-associated condition related to low back pain, while its consequences are responsible for over 90% of spine surgical procedures. In clinical practice, grading of LDD by inspecting MRI is a necessary step to make a suitable treatment plan. This step purely relies on physicians manual inspection so that it brings the unbearable tediousness and inefficiency. An automated method for grading of LDD is highly desirable. However, the technical implementation faces a big challenge from class ambiguity, which is typical in medical image classification problems with a large number of classes. This typical challenge is derived from the complexity and diversity of medical images, which lead to a serious class overlapping and brings a great challenge in discriminating different classes. To solve this problem, we proposed an automated grading approach, which is based on supervised distance metric learning to classify the input discs into four class labels (0: normal, 1: slight, 2: marked, 3: severe). By learning distance metrics from labeled instances, an optimal distance metric is modeled and with two attractive advantages: (1) keeps images from the same classes close, and (2) keeps images from different classes far apart. The experiments, performed in 93 subjects, demonstrated the superiority of our method with accuracy 0.9226, sensitivity 0.9655, specificity 0.9083, F-score 0.8615. With our approach, physicians will be free from the tediousness and patients will be provided an effective treatment.

Transmitting and processing electronic prescriptions: experiences of physician practices and pharmacies

PubMed Central

Cross, Dori A; Boukus, Ellyn R; Cohen, Genna R

2011-01-01

Objective A core feature of e-prescribing is the electronic exchange of prescription data between physician practices and pharmacies, which can potentially improve the efficiency of the prescribing process and reduce medication errors. Barriers to implementing this feature exist, but they are not well understood. This study's objectives were to explore recent physician practice and pharmacy experiences with electronic transmission of new prescriptions and renewals, and identify facilitators of and barriers to effective electronic transmission and pharmacy e-prescription processing. Design Qualitative analysis of 114 telephone interviews conducted with representatives from 97 organizations between February and September 2010, including 24 physician practices, 48 community pharmacies, and three mail-order pharmacies actively transmitting or receiving e-prescriptions via Surescripts. Results Practices and pharmacies generally were satisfied with electronic transmission of new prescriptions but reported that the electronic renewal process was used inconsistently, resulting in inefficient workarounds for both parties. Practice communications with mail-order pharmacies were less likely to be electronic than with community pharmacies because of underlying transmission network and computer system limitations. While e-prescribing reduced manual prescription entry, pharmacy staff frequently had to complete or edit certain fields, particularly drug name and patient instructions. Conclusions Electronic transmission of new prescriptions has matured. Changes in technical standards and system design and more targeted physician and pharmacy training may be needed to address barriers to e-renewals, mail-order pharmacy connectivity, and pharmacy processing of e-prescriptions. PMID:22101907

A Systems Approach to Agricultural Biosecurity.

PubMed

Anand, Manish

This article highlights the importance of systems approaches in addressing agricultural biosecurity threats. On the basis of documentary analysis and stakeholder interaction, a brief survey of agricultural biosecurity threats and vulnerabilities from global and Indian perspectives is provided, followed by an exploration of technological and institutional capabilities. Finally, a perspective on the agricultural disease diagnostic networks is provided, drawing instances from global developments. Technical barriers to agroterrorism are lower than those to human-targeted bioterrorism, and the sector is unique as even a very small disease outbreak could prompt international export restrictions. Key vulnerabilities in the agriculture sector stem from, among others, the structure of agricultural production; insufficient monitoring, surveillance, and controls systems at the borders and in the food chain; inefficient systems for reporting unusual occurrences and outbreaks of disease; and lack of sufficiently trained human resources capable of recognizing or treating transboundary pathogens and diseases. An assessment of technology and institutions pertaining to crop and animal protection management suggests certain gaps. Investment in developing new technologies for civilian application in agriculture, as well as for legitimate actions pertaining to defense, detection, protection, and prophylaxis, and in upgrading laboratory facilities can increase the agricultural sector's level of preparedness for outbreaks. To address potential threats and vulnerabilities of agroterrorism effectively requires the development of a comprehensive strategy and a combined, interagency approach, ideally on an international level. It is proposed that a systems-oriented approach for developing knowledge and innovation networks and strengthening skills and capacities would enable a more resilient agricultural biosecurity system.

Nitroethane, 2-nitro-methyl-propionate and dimethyl-2-nitroglutarate markedly reduce ruminal methane production without adversely affecting ruminal fermentation

USDA-ARS?s Scientific Manuscript database

Ruminal methanogenesis is considered a digestive inefficiency that results in the loss of 2-12% of the host’s gross energy intake and accounts for nearly 20% of the United States’ annual CH4 emissions. The objective of the present experiment was to evaluate the effects of the known CH4 inhibitor, n...

DOE Office of Scientific and Technical Information (OSTI.GOV)

Podoshvedov, S. A., E-mail: podoshvedov@mail.ru

A method to generate Schroedinger cat states in free propagating optical fields based on the use of displaced states (or displacement operators) is developed. Some optical schemes with photon-added coherent states are studied. The schemes are modifications of the general method based on a sequence of displacements and photon additions or subtractions adjusted to generate Schroedinger cat states of a larger size. The effects of detection inefficiency are taken into account.

Scenarios for Russian Agricultural Development to 2021

DTIC Science & Technology

2011-12-01

dependence on government intervention in both good times and bad, and an unwieldy, inefficient bureaucracy strained to effectively carry out the myriad...information is estimated to average 1 hour per response, including the time for reviewing instruction, searching existing data sources, gathering and...issue analysis. Emerging issue analysis begins with the premise that problems develop gradually over time , and are often ignored until they reach

The effects of phytase supplementation on performance and phosphorus excretion from broiler chickens fed low phosphorus-containing diets based on normal or low-phytic acid barley

USDA-ARS?s Scientific Manuscript database

: Long term application of poultry manure can lead to soil phosphorus (P) accumulation and the potential P transport into waterbodies which can contribute to eutrophication of freshwater systems. One reason for this accumulation of soil P is due to the inefficiency of poultry to utilize the P in f...

Harnessing the complexity of education with information technology

NASA Astrophysics Data System (ADS)

Gershenson, Carlos

2015-05-01

Education at all levels is facing several challenges in most countries, such as low quality, high costs, lack of educators, and unsatisfied student demand. Traditional approaches are becoming unable to deliver the required education. Several causes for this inefficiency can be identified. I argue that beyond specific causes, the lack of effective education is related to complexity. However, information technology is helping us overcome this complexity.

Time Management Abilities of School Principals According to Gender: A Case Study in Selected Gauteng Schools

ERIC Educational Resources Information Center

Botha, R. J.

2013-01-01

According to the literature on school effectiveness and school improvement and the role of the school principal in this regard, the lack of time management skills and abilities among school principals can be regarded as one of the main factors that lead to principal inefficiency and ineffectiveness in the school context. But, how do male and…

Liver morphometrics and metabolic blood profile across divergent phenotypes for feed efficiency in the bovine.

PubMed

Montanholi, Yuri Regis; Haas, Livia Sadocco; Swanson, Kendall Carl; Coomber, Brenda Lynn; Yamashiro, Shigeto; Miller, Stephen Paul

2017-04-26

Feed costs are a major expense in the production of beef cattle. Individual variation in the efficiency of feed utilization may be evident through feed efficiency-related phenotypes such as those related to major energetic sinks. Our objectives were to assess the relationships between feed efficiency with liver morphometry and metabolic blood profile in feedlot beef cattle. Two populations (A = 112 and B = 45) of steers were tested for feed efficiency. Blood from the 12 most (efficient) and 12 least feed inefficient (inefficient) steers from population A was sampled hourly over the circadian period. Blood plasma samples were submitted for analysis on albumin, aspartate aminotransferase, γ-glutamyl transpeptidase urea, cholesterol, creatinine, alkaline phosphatase, creatine kinase, lipase, carbon dioxide, β-hydroxybutyrate, acetate and bile acids. Liver tissue was also harvested from 24 steers that were blood sampled from population A and the 10 steers with divergent feed efficiency in each tail of population B was sampled for microscopy at slaughter. Photomicroscopy images were taken using the portal triad and central vein as landmarks. Histological quantifications included cross-sectional hepatocyte perimeter and area, hepatocyte nuclear area and nuclei area as proportion of the hepatocyte area. The least square means comparison between efficient and inefficient steers for productive performance and liver morphometry and for blood analytes data were analyzed using general linear model and mixed model procedures of SAS, respectively. No differences were observed for liver weight; however, efficient steers had larger hepatocyte (i.e. hepatocyte area at the porta triad 323.31 vs. 286.37 µm 2 ) and nuclei dimensions at portal triad and central vein regions, compared with inefficient steers. The metabolic profile indicated efficient steers had lower albumin (36.18 vs. 37.65 g/l) and cholesterol (2.62 vs. 3.05 mmol/l) and higher creatinine (118.59 vs. 110.50 mmol/l) and carbon dioxide (24.36 vs. 23.65 mmol/l) than inefficient steers. Improved feed efficiency is associated with increased metabolism by the liver (enlarged hepatocytes and no difference on organ size), muscle (higher creatinine) and whole body (higher carbon dioxide); additionally, efficient steers had reduced bloodstream pools of albumin and cholesterol. These metabolic discrepancies between feed efficient and inefficient cattle may be determinants of productive performance.

Evaluation on the efficiencies of county-level Centers for Disease Control and Prevention in China: results from a national survey.

PubMed

Li, Chengyue; Sun, Mei; Shen, Jay J; Cochran, Christopher R; Li, Xiaojiao; Hao, Mo

2016-09-01

The Chinese government has greatly increased funding for disease control and prevention since the 2003 Severe Acute Respiration Syndrome crisis, but it is also concerned whether these increased resources have been used efficiently to improve public health services. We aimed to assess the efficiency of county-level Centers for Disease Control and Prevention (CDCs) of China and to identify strategies for optimising their performance. A total of 446 county-level CDCs were selected based on systematic sampling throughout China. The data envelopment analysis framework was used to calculate the efficiency score of sampled CDCs in 2010. The Charnes, Cooper and Rhodes (CCR) model was applied to calculate the overall and scale efficiency, and the Banker, Charnes and Cooper (BCC) model was used to assess technical efficiency. Models included three inputs and seven outputs. A projection analysis was conducted to identify the difference between projection value and actual value for inputs and outputs. The average overall efficiency score of CDCs was 0.317, and the average technical efficiency score was 0.442 and 88.3% with decreasing returns to scale. Projection analysis indicated that all seven categories of outputs were underproduced. CDCs in the eastern region tended to perform better than CDCs in the middle and the western region. Most county-level CDCs in China were operated inefficiently. Emphasis should be put on increasing staff and general operating expenses through current governmental funding, upgrading healthcare providers' competencies and enhancing the standardisation of operational management, so that CDCs could utilise their resources more efficiently. © 2016 John Wiley & Sons Ltd.

The role of consensus and culture in children's imitation of inefficient actions.

PubMed

DiYanni, Cara J; Corriveau, Kathleen H; Kurkul, Katelyn; Nasrini, Jad; Nini, Deniela

2015-09-01

A significant body of work has demonstrated children's imitative abilities when learning novel actions. Although some research has examined the role of cultural background in children's imitation of inefficient actions, to our knowledge no research has explored how culture and conformity interact when engaging in imitation. In Study 1, 87 Caucasian American and Chinese American preschoolers were presented with either one model or three models performing an inefficient action. Whereas there were no cultural differences in imitation in the Single Model condition, Chinese Americans were significantly more likely to copy the model's preference for an inefficient tool in the Consensus condition. Children's tool choice was associated with their justification for their choice as well as their memory for the model's action. Study 2 explored the impact of immigration status on the cultural differences in children's tool choice by including 16 first-generation Caucasian American children. When comparing the findings with the rates from Study 1, both groups of Caucasian American preschoolers imitated at rates significantly lower than the Chinese American preschoolers. We suggest that the tool choices of Caucasian American children relate to a tendency to engage in a perceptually driven mode of learning, whereas the choices of the Chinese American children reflect a greater likelihood to use a socially driven mode. Copyright © 2015 Elsevier Inc. All rights reserved.

Cost inefficiency under financial strain: a stochastic frontier analysis of hospitals in Washington State through the Great Recession.

PubMed

Izón, Germán M; Pardini, Chelsea A

2017-06-01

The importance of increasing cost efficiency for community hospitals in the United States has been underscored by the Great Recession and the ever-changing health care reimbursement environment. Previous studies have shown mixed evidence with regards to the relationship between linking hospitals' reimbursement to quality of care and cost efficiency. Moreover, current evidence suggests that not only inherently financially disadvantaged hospitals (e.g., safety-net providers), but also more financially stable providers, experienced declines to their financial viability throughout the recession. However, little is known about how hospital cost efficiency fared throughout the Great Recession. This study contributes to the literature by using stochastic frontier analysis to analyze cost inefficiency of Washington State hospitals between 2005 and 2012, with controls for patient burden of illness, hospital process of care quality, and hospital outcome quality. The quality measures included in this study function as central measures for the determination of recently implemented pay-for-performance programs. The average estimated level of hospital cost inefficiency before the Great Recession (10.4 %) was lower than it was during the Great Recession (13.5 %) and in its aftermath (14.1 %). Further, the estimated coefficients for summary process of care quality indexes for three health conditions (acute myocardial infarction, pneumonia, and heart failure) suggest that higher quality scores are associated with increased cost inefficiency.

A Potential Synergy between Incomplete Arsenic Methylation Capacity and Demographic Characteristics on the Risk of Hypertension: Findings from a Cross-Sectional Study in an Arsenic-Endemic Area of Inner Mongolia, China

PubMed Central

Li, Yongfang; Wang, Da; Li, Xin; Zheng, Quanmei; Sun, Guifan

2015-01-01

Inefficient arsenic methylation capacity has been associated with various health hazards induced by arsenic. In this study, we aimed to explore the interaction effect of lower arsenic methylation capacity with demographic characteristics on hypertension risk. A total of 512 adult participants (126 hypertension subjects and 386 non-hypertension subjects) residing in an arsenic-endemic area in Inner Mongolia, China were included. Urinary levels of inorganic arsenic (iAs), monomethylarsonic acid (MMA), and dimethylarsinic acid (DMA) were measured for all subjects. The percentage of urinary arsenic metabolites (iAs%, MMA%, and DMA%), primary methylation index (PMI) and secondary methylation index (SMI) were calculated to assess arsenic methylation capacity of individuals. Results showed that participants carrying a lower methylation capacity, which is characterized by lower DMA% and SMI, have a higher risk of hypertension compared to their corresponding references after adjusting for multiple confounders. A potential synergy between poor arsenic methylation capacity (higher MMA%, lower DMA% and SMI) and older age or higher BMI were detected. The joint effects of higher MMA% and lower SMI with cigarette smoking also suggest some evidence of synergism. The findings of present study indicated that inefficient arsenic methylation capacity was associated with hypertension and the effect might be enhanced by certain demographic factors. PMID:25837203

Balancing Hydronic Systems in Multifamily Buildings

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ruch, R.; Ludwig, P.; Maurer, T.

2014-07-01

In multifamily hydronic systems, temperature imbalance may be caused by undersized piping, improperly adjusted balancing valves, inefficient water temperature and flow levels, and owner/occupant interaction with the boilers, distribution and controls. The effects of imbalance include tenant discomfort, higher energy use intensity and inefficient building operation. This paper explores cost-effective distribution upgrades and balancing measures in multifamily hydronic systems, providing a resource to contractors, auditors, and building owners on best practices to improve tenant comfort and lower operating costs. The research was conducted by The Partnership for Advanced Residential Retrofit (PARR) in conjunction with Elevate Energy. The team surveyed existingmore » knowledge on cost-effective retrofits for optimizing distribution in typical multifamily hydronic systems, with the aim of identifying common situations and solutions, and then conducted case studies on two Chicago area buildings with known balancing issues in order to quantify the extent of temperature imbalance. At one of these buildings a booster pump was installed on a loop to an underheated wing of the building. This study found that unit temperature in a multifamily hydronic building can vary as much as 61 degrees F, particularly if windows are opened or tenants use intermittent supplemental heating sources like oven ranges. Average temperature spread at the building as a result of this retrofit decreased from 22.1 degrees F to 15.5 degrees F.« less

Building America Case Study: Balancing Hydronic Systems in Multifamily Buildings, Chicago, Illinois (Fact Sheet)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

2014-09-01

In multifamily hydronic systems, temperature imbalance may be caused by undersized piping, improperly adjusted balancing valves, inefficient water temperature and flow levels, and owner/occupant interaction with the boilers, distribution and controls. The effects of imbalance include tenant discomfort, higher energy use intensity and inefficient building operation. This paper explores cost-effective distribution upgrades and balancing measures in multifamily hydronic systems, providing a resource to contractors, auditors, and building owners on best practices to improve tenant comfort and lower operating costs. The research was conducted by The Partnership for Advanced Residential Retrofit (PARR) in conjunction with Elevate Energy. The team surveyed existingmore » knowledge on cost-effective retrofits for optimizing distribution in typical multifamily hydronic systems, with the aim of identifying common situations and solutions, and then conducted case studies on two Chicago area buildings with known balancing issues in order to quantify the extent of temperature imbalance. At one of these buildings a booster pump was installed on a loop to an underheated wing of the building. This study found that unit temperature in a multifamily hydronic building can vary as much as 61 degrees F, particularly if windows are opened or tenants use intermittent supplemental heating sources like oven ranges. Average temperature spread at the building as a result of this retrofit decreased from 22.1 degrees F to 15.5 degrees F.« less

Efficacy of a numerical value of a fixed-effect estimator in stochastic frontier analysis as an indicator of hospital production structure.

PubMed

Kawaguchi, Hiroyuki; Hashimoto, Hideki; Matsuda, Shinya

2012-09-22

The casemix-based payment system has been adopted in many countries, although it often needs complementary adjustment taking account of each hospital's unique production structure such as teaching and research duties, and non-profit motives. It has been challenging to numerically evaluate the impact of such structural heterogeneity on production, separately of production inefficiency. The current study adopted stochastic frontier analysis and proposed a method to assess unique components of hospital production structures using a fixed-effect variable. There were two stages of analyses in this study. In the first stage, we estimated the efficiency score from the hospital production function using a true fixed-effect model (TFEM) in stochastic frontier analysis. The use of a TFEM allowed us to differentiate the unobserved heterogeneity of individual hospitals as hospital-specific fixed effects. In the second stage, we regressed the obtained fixed-effect variable for structural components of hospitals to test whether the variable was explicitly related to the characteristics and local disadvantages of the hospitals. In the first analysis, the estimated efficiency score was approximately 0.6. The mean value of the fixed-effect estimator was 0.784, the standard deviation was 0.137, the range was between 0.437 and 1.212. The second-stage regression confirmed that the value of the fixed effect was significantly correlated with advanced technology and local conditions of the sample hospitals. The obtained fixed-effect estimator may reflect hospitals' unique structures of production, considering production inefficiency. The values of fixed-effect estimators can be used as evaluation tools to improve fairness in the reimbursement system for various functions of hospitals based on casemix classification.

Effective Transition Management: The Seamless System

NASA Technical Reports Server (NTRS)

Burke, Marty

1995-01-01

In this age of shrinking resources, cost avoidance has become as critical as direct cost savings. There is no doubt that Effective Transition Management (ETM) achieves this aim. What then, is ETM and how does it achieve its goal? It is the introduction and use of a hierarchical decision model and computerized tracking system which successfully integrates capital acquisition into the support base. You will discover that because this proven system is generic, compatible and flexible, its applications are virtually unlimited. It is this highly dynamic process which I would like to share with you. Skilled specialists are now rotated rapidly through acquisition programs on a requirements-driven basis. Managers continue their quest for inefficient areas to trim, slash or cut. However, there is one area of operations in every major corporation and government department that, as yet, has not received the attention it deserves. This essential element is Transition Management. Capital acquisitions, at some point, must be handed off to a support matrix for the 'in-service' phase of their life cycle. Most of us who have been on the receiving end can usually cite outrageous examples of adjustment, recovery or disaster. This means buying what amounts to a second initial sparing package, re-aligning the range and depth of inventory to match a changed maintenance concept, interpreting contractor-developed configuration control data or ensuring that the latest information is contained in the technical publications. This list is endless. For major purchases, this 'in-service' phase is often fifteen, twenty or more years. The least desirable, yet most common condition, is to suffer up to five years of recovering from errors or omissions after the transition to the support matrix occurs. Without ETM, making new equipment fully operational may thus become a long and costly process.

Incorporation of public hospitals: a "silver bullet" against overcapacity, managerial bottlenecks and resource constraints? Case studies from Austria and Estonia.

PubMed

Fidler, Armin H; Haslinger, Reinhard R; Hofmarcher, Maria M; Jesse, Maris; Palu, Toomas

2007-05-01

This paper presents a new approach for incorporating public hospitals by contrasting the experience from an "old" EU country (Austria) with a new EU member state (Estonia). In the EU (including the new member states) hospital overcapacity is a serious problem, from a technical, fiscal and political perspective. Few countries have succeeded in establishing an appropriate framework for resource management and for guaranteeing long-term financial viability of their hospital network. Many countries are in search of effective policies for improved hospital management and more cost-effective resource use in the health sector. Over the past decade, experiences in Austria and Estonia have emerged as innovative examples which may provide lessons for other EU countries and beyond. This paper describes the evolution of public hospitals from public budgetary units and public management to incorporated autonomous organizations under private corporate law, resulting in a contractual relationship between (public) owners and private hospital management. Outdated and inefficient public sector structures were replaced by more agile corporate management. The arrangement allows for investments, operating costs and budgeting according to strategic business goals as opposed to political "fiat". Shielding hospitals from local political influence is an important aspect of this concept. Horizontal integration through networking of public hospitals and introducing private management helps create a new corporate culture, allowing for more flexibility to achieve efficiencies through downsizing and economies of scale. Based on contracts the new balance between ownership and managerial functions create strong incentives for a more business-like, results-oriented and consumer-friendly management. This was achieved both in Austria and Estonia in a politically sensitive way, adopting a long-term vision and by protecting the interests of hospital owners and staff.

Incinerator toxic emissions: a brief summary of human health effects with a note on regulatory control.

PubMed

Rowat, S C

1999-05-01

Toxic emissions from municipal solid waste (MSW) and hazardous waste incineration are discussed, with reference to recent reviews and to government standards and controls. Studies of known effects of aromatic hydrocarbons, other organics, dioxins, metals, and gases, on fish, soils, plants, and particularly humans are briefly reviewed. A summary of potential problems with existing and proposed incineration is developed, including: (1) lack of toxicity data on unidentified organic emissions; (2) unavoidability of hazardous metal emissions as particles and volatiles; (3) inefficient stack operation resulting in unknown amounts of increased emissions; (4) formation in the stack of highly toxic dioxins and furans, especially under inefficient conditions, and their build-up in the environment and in human tissue; (5) the lack of adequate disposal techniques for incinerator fly ash and wash-water; (6) the contribution of emitted gases such as NO2, SO2 and HCL to smog, acid rain, and the formation of ozone, and the deleterious effects of these on human respiratory systems; (7) the effects and build-up in human tissue of other emitted organics such as benzene, toluene, polychlorinated biphenyls (PCBs), alkanes, alcohols, and phenols; (8) lack of pollution-control and real-time efficiency-monitoring equipment in existing installations. The inability of regulatory bodies historically to ensure compliance with emission standards is discussed, and a concluding opinion is offered that it is inadvisable to engage in new incinerator construction with present knowledge and conditions.

Improving the effectiveness of service delivery in the public healthcare sector: the case of ophthalmology services in Malaysia.

PubMed

Foo, Chee Yoong; Lim, Ka Keat; Sivasampu, Sheamini; Dahian, Kamilah Binti; Goh, Pik Pin

2015-08-28

Rising demand of ophthalmology care is increasingly straining Malaysia's public healthcare sector due to its limited human and financial resources. Improving the effectiveness of ophthalmology service delivery can promote national policy goals of population health improvement and system sustainability. This study examined the performance variation of public ophthalmology service in Malaysia, estimated the potential output gain and investigated several factors that might explain the differential performance. Data for 2011 and 2012 on 36 ophthalmology centres operating in the Ministry of Health hospitals were used in this analysis. We first consulted a panel of ophthalmology service managers to understand the production of ophthalmology services and to verify the production model. We then assessed the relative performance of these centres using Data Envelopment Analysis (DEA). Efficiency scores (ES) were decomposed into technical, scale, and congestion component. Potential increase in service output was estimated. Sensitivity analysis of model changes was performed and stability of the result was assessed using bootstrap approach. Second stage Tobit regression was conducted to determine if hospital type, availability of day services and population characteristics were related to the DEA scores. In 2011, 33% of the ophthalmology centres were found to have ES > 1 (mean ES = 1.10). Potential output gains were 10% (SE ± 2.92), 7.4% (SE ± 2.06), 6.9% (SE ± 1.97) if the centres could overcome their technical, scale and congestion inefficiencies. More centres moved to the performance frontier in 2012 (mean ES = 1.07), with lower potential output gain. The model used has good stability. Robustness checks show that the DEA correctly identified low performing centres. Being in state hospital was significantly associated with better performance. Using DEA to benchmarking service performance of ophthalmology care could provide insights for policy makers and service managers to intuitively visualise the overall performance of resource use in an otherwise difficult to assess scenario. The considerable potential output gain estimated indicates that effort should be invested to understand what drove the performance variation and optimise them. Similar performance assessment should be undertaken for other healthcare services in the country in order to work towards a sustainable health system.

Strategies for Optimizing Strength, Power, and Muscle Hypertrophy in Women.

DTIC Science & Technology

1997-09-01

the injury risks and inefficiencies of other methods for the more sophisticated assessment of human muscular strength and power. To provide...an environment of total safety. Limiting catches prevent injury through falling or loss of control of the loaded bar and a specially designed...J., Rodman, K.W., and Sebolt, D.R. The effect of endurance running on training adaptations in women participating in a weightlifting program. J

Integrative data mining of high-throughput in vitro screens, in vivo data, and disease information to identify Adverse Outcome Pathway (AOP) signatures:ToxCast high-throughput screening data and Comparative Toxicogenomics Database (CTD) as a case study.

EPA Science Inventory

The Adverse Outcome Pathway (AOP) framework provides a systematic way to describe linkages between molecular and cellular processes and organism or population level effects. The current AOP assembly methods however, are inefficient. Our goal is to generate computationally-pr...

Traffic off-balancing algorithm for energy efficient networks

NASA Astrophysics Data System (ADS)

Kim, Junhyuk; Lee, Chankyun; Rhee, June-Koo Kevin

2011-12-01

Physical layer of high-end network system uses multiple interface arrays. Under the load-balancing perspective, light load can be distributed to multiple interfaces. However, it can cause energy inefficiency in terms of the number of poor utilization interfaces. To tackle this energy inefficiency, traffic off-balancing algorithm for traffic adaptive interface sleep/awake is investigated. As a reference model, 40G/100G Ethernet is investigated. We report that suggested algorithm can achieve energy efficiency while satisfying traffic transmission requirement.

Balancing Hydronic Systems in Multifamily Buildings

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ruch, Russell; Ludwig, Peter; Maurer, Tessa

2014-07-01

In multifamily hydronic systems, temperature imbalance may be caused by undersized piping, improperly adjusted balancing valves, inefficient water temperature and flow levels, and owner/occupant interaction with the boilers, distribution, and controls. The imbalance leads to tenant discomfort, higher energy use intensity, and inefficient building operation. This research, conducted by Building America team Partnership for Advanced Residential Retrofit, explores cost-effective distribution upgrades and balancing measures in multifamily hydronic systems, providing a resource to contractors, auditors, and building owners on best practices to improve tenant comfort and lower operating costs. The team surveyed existing knowledge on cost-effective retrofits for optimizing distribution inmore » typical multifamily hydronic systems, with the aim of identifying common situations and solutions, and then conducted case studies on two Chicago area buildings with known balancing issues in order to quantify the extent of temperature imbalance. At one of these buildings a booster pump was installed on a loop to an underheated wing of the building. This study found that unit temperature in a multifamily hydronic building can vary as much as 61°F, particularly if windows are opened or tenants use intermittent supplemental heating sources like oven ranges. Average temperature spread at the building as a result of this retrofit decreased from 22.1°F to 15.5°F.« less

Globalization of health care delivery in the United States through medical tourism.

PubMed

Kumar, Sameer; Breuing, Richard; Chahal, Rajneet

2012-01-01

This study highlights some of the inefficiencies in the U.S. health care system and determines what effect medical tourism has had on the U.S. and global health care supply chains. This study also calls attention to insufficient health communication efforts to inform uninsured or underinsured medical tourists about the benefits and risks and determines the managerial and cost implications of various surgical procedures on the global health care system into the future. This study evaluated 3 years (2005, 2007, and 2011) of actual and projected surgical cost data. The authors selected 3 countries for analysis: the United States, India, and Thailand. The surgeries chosen for evaluation were total knee replacement (knee arthroplasty), hip replacement (hip arthroplasty), and heart bypass (coronary artery bypass graft). Comparisons of costs were made using Monte Carlo simulation with variability encapsulated by triangular distributions. The results are staggering. In 2005, the amount of money lost to India and Thailand on just these 3 surgeries because of cost inefficiencies in the U.S. health care system was between 1.3 to 2 billion dollars. In 2011, because many more Americans are expected to travel overseas for health care, this amount is anticipated to rise to between 20 and 30.2 billion dollars. Therefore, more attention should be paid to health communication efforts that truly illustrate the benefits/risks of medical travel. The challenge of finding reliable data for surgeries performed and associated surgical cost estimates was mitigated by the use of a Monte Carlo simulation of triangular distributions. The implications from this study are clear: If the U.S. health care industry is unable to eliminate waste and inefficiency and thus curb rising costs, it will continue to lose surgical revenue to foreign health providers. Copyright © Taylor & Francis Group, LLC

[Prevalence of and factors related to depression in high school students].

PubMed

Eskin, Mehmet; Ertekin, Kamil; Harlak, Hacer; Dereboy, Ciğdem

2008-01-01

The study aimed at investigating the prevalence of and factors related to depression in high school students. A total of 805 (n = 367 girls; n = 438 boys) first year students from three high schools in the city of Aydin filled in a self-report questionnaire that contained questions about socio-demographics, academic achievement and religious belief. It included also a depression rating scale, social support scale, problem solving inventory and an assertiveness scale. T-tests, chi-square tests, Pearson moment products correlation coefficients, and logistic regression analysis were used to analyze the data. 141 students (17.5%) scored on and above the cut-off point on the Children Depression Inventory (CDI). In the first regression analyses low self-esteem, low grade point average (GPA) and low perceived social support from friends in boys, and low self-esteem, low paternal educational level and low social support from friends were the predictors of girls' depression. When self-esteem scores were excluded, low GPA, low perceived social support from friends and family, and inefficient problem solving skills were predictors of depression in boys; low perceived social support from friends and family, low paternal educational level, and inefficient problem solving skills were the independent predictors of depression in girls. Depression is prevalent in high school students. Low self-esteem, low perceived social support from peers and family, and inefficient problem solving skills appears to be risk factors for adolescent depression. Low GPA for boys and low paternal education for girls were gender specific risk factors. Psychosocial interventions geared for increasing self-esteem, social support and problem solving skills may be effective in the prevention and treatment of adolescent depression.

Time-varying long term memory in the European Union stock markets

NASA Astrophysics Data System (ADS)

Sensoy, Ahmet; Tabak, Benjamin M.

2015-10-01

This paper proposes a new efficiency index to model time-varying inefficiency in stock markets. We focus on European stock markets and show that they have different degrees of time-varying efficiency. We observe that the 2008 global financial crisis has an adverse effect on almost all EU stock markets. However, the Eurozone sovereign debt crisis has a significant adverse effect only on the markets in France, Spain and Greece. For the late members, joining EU does not have a uniform effect on stock market efficiency. Our results have important implications for policy makers, investors, risk managers and academics.

Automated quality control in a file-based broadcasting workflow

NASA Astrophysics Data System (ADS)

Zhang, Lina

2014-04-01

Benefit from the development of information and internet technologies, television broadcasting is transforming from inefficient tape-based production and distribution to integrated file-based workflows. However, no matter how many changes have took place, successful broadcasting still depends on the ability to deliver a consistent high quality signal to the audiences. After the transition from tape to file, traditional methods of manual quality control (QC) become inadequate, subjective, and inefficient. Based on China Central Television's full file-based workflow in the new site, this paper introduces an automated quality control test system for accurate detection of hidden troubles in media contents. It discusses the system framework and workflow control when the automated QC is added. It puts forward a QC criterion and brings forth a QC software followed this criterion. It also does some experiments on QC speed by adopting parallel processing and distributed computing. The performance of the test system shows that the adoption of automated QC can make the production effective and efficient, and help the station to achieve a competitive advantage in the media market.

Effect of exercise training on ventilatory efficiency in patients with heart disease: a review.

PubMed

Prado, D M L; Rocco, E A; Silva, A G; Rocco, D F; Pacheco, M T; Furlan, V

2016-06-20

The analysis of ventilatory efficiency in cardiopulmonary exercise testing has proven useful for assessing the presence and severity of cardiorespiratory diseases. During exercise, efficient pulmonary gas exchange is characterized by uniform matching of lung ventilation with perfusion. By contrast, mismatching is marked by inefficient pulmonary gas exchange, requiring increased ventilation for a given CO2 production. The etiology of increased and inefficient ventilatory response to exercise in heart disease is multifactorial, involving both peripheral and central mechanisms. Exercise training has been recommended as non-pharmacological treatment for patients with different chronic cardiopulmonary diseases. In this respect, previous studies have reported improvements in ventilatory efficiency after aerobic exercise training in patients with heart disease. Against this background, the primary objective of the present review was to discuss the pathophysiological mechanisms involved in abnormal ventilatory response to exercise, with an emphasis on both patients with heart failure syndrome and coronary artery disease. Secondly, special focus was dedicated to the role of aerobic exercise training in improving indices of ventilatory efficiency among these patients, as well as to the underlying mechanisms involved.

Solar wind conditions leading to efficient radiation belt electron acceleration: A superposed epoch analysis

DOE PAGES

Li, W.; Thorne, R. M.; Bortnik, J.; ...

2015-09-07

In this study by determining preferential solar wind conditions leading to efficient radiation belt electron acceleration is crucial for predicting radiation belt electron dynamics. Using Van Allen Probes electron observations (>1 MeV) from 2012 to 2015, we identify a number of efficient and inefficient acceleration events separately to perform a superposed epoch analysis of the corresponding solar wind parameters and geomagnetic indices. By directly comparing efficient and inefficient acceleration events, we clearly show that prolonged southward Bz, high solar wind speed, and low dynamic pressure are critical for electron acceleration to >1 MeV energies in the heart of the outermore » radiation belt. We also evaluate chorus wave evolution using the superposed epoch analysis for the identified efficient and inefficient acceleration events and find that chorus wave intensity is much stronger and lasts longer during efficient electron acceleration events, supporting the scenario that chorus waves play a key role in MeV electron acceleration.« less

Adopting new medical technologies in Russian hospitals: what causes inefficiency? (qualitative study).

PubMed

Shishkin, Sergey; Zasimova, Liudmila

2018-01-01

The adoption of new medical technologies often generates losses in efficiency associated with the excess or insufficient acquisition of new equipment, an inappropriate choice (in terms of economic and clinical parameters) of medical equipment, and its poor use. Russia is a good example for exploring the problem of the ineffective adoption of new medical technologies due to the massive public investment in new equipment for medical institutions in 2006-2013. This study examines the procurement of new technologies in Russian hospitals to find the main causes of inefficiency. The research strategy was based on in-depth semistructured interviews with representatives of prominent actors (regional health care authorities, hospital executives, senior physicians). The main result is that inefficiencies arise from the contradiction between hospitals' and authorities' motivation for acquiring new technologies: hospitals tend to adopt technologies which bring benefits to their department heads and physicians and minimize maintenance and servicing costs, while the authorities' main concern is the initial cost of the technology.

Gait Analysis of Symptomatic Flatfoot in Children: An Observational Study.

PubMed

Kim, Ha Yong; Shin, Hyuck Soo; Ko, Jun Hyuck; Cha, Yong Han; Ahn, Jae Hoon; Hwang, Jae Yeon

2017-09-01

Flatfoot deformity is a lever arm disease that incurs kinetic inefficiency during gait. The purpose of this study was to measure the degree of kinetic inefficiency by comparing the gait analysis data of a flatfoot group with a normal control group. The patient group consisted of 26 children (21 males and 5 females) with symptomatic flatfoot. They were examined with gait analysis between May 2005 and February 2014. Exclusion criteria were patients with secondary flatfoot caused by neuromuscular disorders, tarsal coalition, vertical talus, or others. Patients' mean age was 9.5 years (range, 7 to 13 years). The gait analysis data of the study group and the normal control group were compared. The mean vertical ground reaction force (GRF) in the push-off phase was 0.99 for the patient group and 1.15 for the control group ( p < 0.05). The mean ankle moment in the sagittal plane during the push-off phase was 0.89 for the patient group and 1.27 for the control group ( p < 0.05). The mean ankle power in the sagittal plane during the push-off phase was 1.38 for the patient group and 2.52 for the control group ( p < 0.05). The aforementioned results show that patients with pes planovalgus had a reduction of moment, power, and GRF in the push-off phase during gait. Symptomatic flatfeet had a moment inefficiency of 30% and power inefficiency of 45% during gait compared to feet with preserved medial longitudinal arches.

Z-Selective Metathesis Homocoupling of 1,3-Dienes by Molybdenum and Tungsten Monoaryloxide Pyrrolide (MAP) Complexes

PubMed Central

Townsend, Erik M.; Schrock, Richard R.; Hoveyda, Amir H.

2012-01-01

Molybdenum or tungsten MAP complexes that contain OHIPT as the aryloxide (hexaisopropylterphenoxide) are effective catalysts for homocoupling of simple (E)-1,3-dienes to give (E,Z,E)-trienes in high yield and with high Z selectivities. A vinylalkylidene MAP species was shown to have the expected syn structure in an X-ray study. MAP catalysts that contain OHMT (hexamethylterphenoxide) are relatively inefficient. PMID:22734508

U.S.-Mexico Policy Coordination: An Assessment of the Twenty-First Century Border Policy Coordination Effort

DTIC Science & Technology

2011-10-28

FINAL 3. DATES COVERED (From - To) September 2011 – October 2011 4. TITLE AND SUBTITLE U.S. – MEXICO POLICY COORDINATION AN...national levels of both governments leading to significant inefficiency on issues related to the border. In 2010, the United States and Mexico ...effort to improve United States border policy coordination with Mexico . This paper assesses the effectiveness of the Twenty-First Century Border policy

Regional Economic Integration in the Developing World: Historical Trends at the Future Viability

DTIC Science & Technology

1994-01-01

elements of these previous integration experiences is essential , as it aids in assessing the future effectiveness of current developing country integration...assessed in order to elements of these previous integration see whether they have avoided the experiences is essential , as it aids in problems that...promote was felt that the inefficiency would only be industries that were more technologically temporary. What was essential was that based, especially

Identification and Development of Biological Markers of Human Exposure to the Insecticide Permethrin

DTIC Science & Technology

2008-04-01

following occupational exposure (Angerer and Ritter, 1997) or healthy volunteers using a shampoo for head lice (Tomalik-Scharte et al., 2005) was subjected...discrepancy is likely due to the inaccuracy and inefficiency of the survey meter. However, the survey meter did provide useful information during the...individual treatments. No adverse effects were reported during the one-week period of the study. Table 3. Dosing procedure monitoring by survey meter

Kinetic Super-Resolution Long-Wave Infrared (KSR LWIR) Thermography Diagnostic for Building Envelopes: Scott AFB, IL

DTIC Science & Technology

2015-08-18

techniques of measuring energy loss due to enve- lope inefficiencies from the built environment. A multi-sensor hardware device attached to the roof of a...at this installa- tion, recommends specific energy conservation measures (ECMs), and quantifies significant potential return on investment. ERDC/CERL...to several thousand square feet, total building square feet was used as a metric to measure the cost effectiveness of handheld versus mobile

Inefficient Mechanical Transmission of Langat (Tick-Borne Encephalitis Virus Complex) Virus by Blood-Feeding Mites (Acari) to Laboratory Mice

DTIC Science & Technology

1993-05-01

AD--A269 706 SPSSHORT C:OMMNUNICATION 8 Inefficient Mechanical Transmission of Langat (Tick-Bornee Encephalitis Virus Complex) Virus by Blood-Feeding...I d after a . iremic blood meal. but onhv immediatelIy after the vi re muo. LANGAT (LGT) VIRUS is a member of the tick- No isolations of LCT virus...Use of ulatus collected in the Ulu Langat Forest re- Laboratory Animals." as promulgated by the Committee on serve, Malaysia. in l959’(Struth 1956

Effect of Phenotypic Residual Feed Intake and Dietary Forage Content on the Rumen Microbial Community of Beef Cattle

PubMed Central

Carberry, Ciara A.; Kenny, David A.; Han, Sukkyan; McCabe, Matthew S.

2012-01-01

Feed-efficient animals have lower production costs and reduced environmental impact. Given that rumen microbial fermentation plays a pivotal role in host nutrition, the premise that rumen microbiota may contribute to host feed efficiency is gaining momentum. Since diet is a major factor in determining rumen community structure and fermentation patterns, we investigated the effect of divergence in phenotypic residual feed intake (RFI) on ruminal community structure of beef cattle across two contrasting diets. PCR-denaturing gradient gel electrophoresis (DGGE) and quantitative PCR (qPCR) were performed to profile the rumen bacterial population and to quantify the ruminal populations of Entodinium spp., protozoa, Fibrobacter succinogenes, Ruminococcus flavefaciens, Ruminococcus albus, Prevotella brevis, the genus Prevotella, and fungi in 14 low (efficient)- and 14 high (inefficient)-RFI animals offered a low-energy, high-forage diet, followed by a high-energy, low-forage diet. Canonical correspondence and Spearman correlation analyses were used to investigate associations between physiological variables and rumen microbial structure and specific microbial populations, respectively. The effect of RFI on bacterial profiles was influenced by diet, with the association between RFI group and PCR-DGGE profiles stronger for the higher forage diet. qPCR showed that Prevotella abundance was higher (P < 0.0001) in inefficient animals. A higher (P < 0.0001) abundance of Entodinium and Prevotella spp. and a lower (P < 0.0001) abundance of Fibrobacter succinogenes were observed when animals were offered the low-forage diet. Thus, differences in the ruminal microflora may contribute to host feed efficiency, although this effect may also be modulated by the diet offered. PMID:22562991

Effect of phenotypic residual feed intake and dietary forage content on the rumen microbial community of beef cattle.

PubMed

Carberry, Ciara A; Kenny, David A; Han, Sukkyan; McCabe, Matthew S; Waters, Sinead M

2012-07-01

Feed-efficient animals have lower production costs and reduced environmental impact. Given that rumen microbial fermentation plays a pivotal role in host nutrition, the premise that rumen microbiota may contribute to host feed efficiency is gaining momentum. Since diet is a major factor in determining rumen community structure and fermentation patterns, we investigated the effect of divergence in phenotypic residual feed intake (RFI) on ruminal community structure of beef cattle across two contrasting diets. PCR-denaturing gradient gel electrophoresis (DGGE) and quantitative PCR (qPCR) were performed to profile the rumen bacterial population and to quantify the ruminal populations of Entodinium spp., protozoa, Fibrobacter succinogenes, Ruminococcus flavefaciens, Ruminococcus albus, Prevotella brevis, the genus Prevotella, and fungi in 14 low (efficient)- and 14 high (inefficient)-RFI animals offered a low-energy, high-forage diet, followed by a high-energy, low-forage diet. Canonical correspondence and Spearman correlation analyses were used to investigate associations between physiological variables and rumen microbial structure and specific microbial populations, respectively. The effect of RFI on bacterial profiles was influenced by diet, with the association between RFI group and PCR-DGGE profiles stronger for the higher forage diet. qPCR showed that Prevotella abundance was higher (P < 0.0001) in inefficient animals. A higher (P < 0.0001) abundance of Entodinium and Prevotella spp. and a lower (P < 0.0001) abundance of Fibrobacter succinogenes were observed when animals were offered the low-forage diet. Thus, differences in the ruminal microflora may contribute to host feed efficiency, although this effect may also be modulated by the diet offered.

Effectiveness of Direct Safety Regulations on Manufacturers and Users of Industrial Machines: Its Implications on Industrial Safety Policies in Republic of Korea.

PubMed

Choi, Gi Heung

2017-03-01

Despite considerable efforts made in recent years, the industrial accident rate and the fatality rate in the Republic of Korea are much higher than those in most developed countries in Europe and North America. Industrial safety policies and safety regulations are also known to be ineffective and inefficient in some cases. This study focuses on the quantitative evaluation of the effectiveness of direct safety regulations such as safety certification, self-declaration of conformity, and safety inspection of industrial machines in the Republic of Korea. Implications on safety policies to restructure the industrial safety system associated with industrial machines are also explored. Analysis of causes in industrial accidents associated with industrial machines confirms that technical causes need to be resolved to reduce both the frequency and the severity of such industrial accidents. Statistical analysis also confirms that the indirect effects of safety device regulation on users are limited for a variety of reasons. Safety device regulation needs to be shifted to complement safety certification and self-declaration of conformity for more balanced direct regulations on manufacturers and users. An example of cost-benefit analysis on conveyor justifies such a transition. Industrial safety policies and regulations associated with industrial machines must be directed towards eliminating the sources of danger at the stage of danger creation, thereby securing the safe industrial machines. Safety inspection further secures the safety of workers at the stage of danger use. The overall balance between such safety regulations is achieved by proper distribution of industrial machines subject to such regulations and the intensity of each regulation. Rearrangement of industrial machines subject to safety certification and self-declaration of conformity to include more movable industrial machines and other industrial machines with a high level of danger is also suggested.

Application of microfluidic technologies to human assisted reproduction.

PubMed

Smith, Gary D; Takayama, Shuichi

2017-04-01

Microfluidics can be considered both a science and a technology. It is defined as the study of fluid behavior at a sub-microliter level and the investigation into its application to cell biology, chemistry, genetics, molecular biology and medicine. There are at least two characteristics of microfluidics, mechanical and biochemical, which can be influential in the field of mammalian gamete and preimplantation embryo biology. These microfluidic characteristics can assist in basic biological studies on sperm, oocyte and preimplantation embryo structure, function and environment. The mechanical and biochemical characteristics of microfluidics may also have practical and/or technical application(s) to assisted reproductive technologies (ART) in rodents, domestic species, endangered species and humans. This review will consider data in mammals, and when available humans, addressing the potential application(s) of microfluidics to assisted reproduction. There are numerous sequential steps in the clinical assisted reproductive laboratory process that work, yet could be improved. Cause and effect relations of procedural inefficiencies can be difficult to identify and/or remedy. Data will be presented that consider microfluidic applications to sperm isolation, oocyte cumulus complex isolation, oocyte denuding, oocyte mechanical manipulation, conventional insemination, intracytoplasmic sperm injection, embryo culture, embryo analysis and oocyte and embryo cryopreservation. While these studies have progressed in animal models, data with human gametes and embryos are significantly lacking. These data from clinical trials are requisite for making future evidence-based decisions regarding the application of microfluidics in human ART. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved.For Permissions, please email: journals.permissions@oup.com.

Microfluidic magnetic fluidized bed for DNA analysis in continuous flow mode.

PubMed

Hernández-Neuta, Iván; Pereiro, Iago; Ahlford, Annika; Ferraro, Davide; Zhang, Qiongdi; Viovy, Jean-Louis; Descroix, Stéphanie; Nilsson, Mats

2018-04-15

Magnetic solid phase substrates for biomolecule manipulation have become a valuable tool for simplification and automation of molecular biology protocols. However, the handling of magnetic particles inside microfluidic chips for miniaturized assays is often challenging due to inefficient mixing, aggregation, and the advanced instrumentation required for effective actuation. Here, we describe the use of a microfluidic magnetic fluidized bed approach that enables dynamic, highly efficient and simplified magnetic bead actuation for DNA analysis in a continuous flow platform with minimal technical requirements. We evaluate the performance of this approach by testing the efficiency of individual steps of a DNA assay based on padlock probes and rolling circle amplification. This assay comprises common nucleic acid analysis principles, such as hybridization, ligation, amplification and restriction digestion. We obtained efficiencies of up to 90% for these reactions with high throughput processing up to 120μL of DNA dilution at flow rates ranging from 1 to 5μL/min without compromising performance. The fluidized bed was 20-50% more efficient than a commercially available solution for microfluidic manipulation of magnetic beads. Moreover, to demonstrate the potential of this approach for integration into micro-total analysis systems, we optimized the production of a low-cost polymer based microarray and tested its analytical performance for integrated single-molecule digital read-out. Finally, we provide the proof-of-concept for a single-chamber microfluidic chip that combines the fluidized bed with the polymer microarray for a highly simplified and integrated magnetic bead-based DNA analyzer, with potential applications in diagnostics. Copyright © 2017 Elsevier B.V. All rights reserved.

Energy, variability and weather finance engineering

NASA Astrophysics Data System (ADS)

Roussis, Dimitrios; Parara, Iliana; Gournari, Panagiota; Moustakis, Yiannis; Dimitriadis, Panayiotis; Iliopoulou, Theano; Koutsoyiannis, Demetris; Karakatsanis, Georgios

2017-04-01

Most types of renewable energies are characterized by intense intermittency, causing significant instabilities to the grid; further requiring additional infrastructure (e.g. pumped-storage) for buffering hydrometeorological uncertainties, as well as complex operational rules for load balancing. In addition, most intermittent renewable units are subsidized, creating significant market inefficiencies. Weather derivatives comprise mature financial tools for integrating successfully the intermittent-load and base-load components into a unified hybrid energy system and establish their operation within a generalized uncertainty management market. With a growing global market share and 46% utilization of this financial tool by the energy industry and 12% by agriculture (that partially concerns biofuel resources), weather derivatives are projected to constitute a critical subsystem of many grids for buffering frequent hydrometeorological risks of low and medium impacts -which are not covered by standard insurance contracts that aim exclusively at extreme events and high financial damages. In this context, we study the attributes of hydrometeorological time series in a remote and small island in Greece, powered by an autonomous hybrid energy system. Upon the results we choose the optimal underlying index and we further compose and engineer a weather derivative with features of a typical option contract -which we consider most flexible and appropriate for the case- to test our assumptions on its beneficiary effects for both the budget of private energy producers and the island's public administration. Acknowledgement: This research is conducted within the frame of the undergraduate course "Stochastic Methods in Water Resources" of the National Technical University of Athens (NTUA). The School of Civil Engineering of NTUA provided moral support for the participation of the students in the Assembly.

Representation of potential information gain to measure the price of anarchy on ISR activities

NASA Astrophysics Data System (ADS)

Ortiz-Peña, Hector J.; Hirsch, Michael; Karwan, Mark; Nagi, Rakesh; Sudit, Moises

2013-05-01

One of the main technical challenges facing intelligence analysts today is effectively determining information gaps from huge amounts of collected data. Moreover, getting the right information to/from the right person (e.g., analyst, warfighter on the edge) at the right time in a distributed environment has been elusive to our military forces. Synchronization of Intelligence, Surveillance, and Reconnaissance (ISR) activities to maximize the efficient utilization of limited resources (both in quantity and capabilities) has become critically important to increase the accuracy and timeliness of overall information gain. Given this reality, we are interested in quantifying the degradation of solution quality (i.e., information gain) as a centralized system synchronizing ISR activities (from information gap identification to information collection and dissemination) moves to a more decentralized framework. This evaluation extends the concept of price of anarchy, a measure of the inefficiency of a system when agents maximize decisions without coordination, by considering different levels of decentralization. Our initial research representing the potential information gain in geospatial and time discretized spaces is presented. This potential information gain map can represent a consolidation of Intelligence Preparation of the Battlefield products as input to automated ISR synchronization tools. Using the coordination of unmanned vehicles (UxVs) as an example, we developed a mathematical programming model for multi-perspective optimization in which each UxV develops its own fight plan to support mission objectives based only on its perspective of the environment (i.e., potential information gain map). Information is only exchanged when UxVs are part of the same communication network.

A coupled agronomic-economic model to consider allocation of brackish irrigation water

NASA Astrophysics Data System (ADS)

Ben-Gal, Alon; Weikard, Hans-Peter; Shah, Syed Hamid Hussain; van der Zee, Sjoerd E. A. T. M.

2013-05-01

In arid and semiarid regions, irrigation water is scarce and often contains high concentrations of salts. To reduce negative effects on crop yields, the irrigated amounts must include water for leaching and therefore exceed evapotranspiration. The leachate (drainage) water returns to water sources such as rivers or groundwater aquifers and increases their level of salinity and the leaching requirement for irrigation water of any sequential user. We develop a conceptual sequential (upstream-downstream) model of irrigation that predicts crop yields and water consumption and tracks the water flow and level of salinity along a river dependent on irrigation management decisions. The model incorporates an agro-physical model of plant response to environmental conditions including feedbacks. For a system with limited water resources, the model examines the impacts of water scarcity, salinity and technically inefficient application on yields for specific crop, soil, and climate conditions. Moving beyond the formulation of a conceptual frame, we apply the model to the irrigation of Capsicum annum on Arava Sandy Loam soil. We show for this case how water application could be distributed between upstream and downstream plots or farms. We identify those situations where it is beneficial to trade water from upstream to downstream farms (assuming that the upstream farm holds the water rights). We find that water trade will improve efficiency except when loss levels are low. We compute the marginal value of water, i.e., the price water would command on a market, for different levels of water scarcity, salinity and levels of water loss.

Managing Sustainable Demand-side Infrastructure for Power System Ancillary Services

NASA Astrophysics Data System (ADS)

Parkinson, Simon Christopher

Widespread access to renewable electricity is seen as a viable method to mitigate carbon emissions, although problematic are the issues associated with the integration of the generation systems within current power system configurations. Wind power plants are the primary large-scale renewable generation technology applied globally, but display considerable short-term supply variability that is difficult to predict. Power systems are currently not designed to operate under these conditions, and results in the need to increase operating reserve in order to guarantee stability. Often, operating conventional generation as reserve is both technically and economically inefficient, which can overshadow positive benefits associated with renewable energy exploitation. The purpose of this thesis is to introduce and assess an alternative method of enhancing power system operations through the control of electric loads. In particular, this thesis focuses on managing highly-distributed sustainable demand-side infrastructure, in the form of heat pumps, electric vehicles, and electrolyzers, as dispatchable short-term energy balancing resources. The main contribution of the thesis is an optimal control strategy capable of simultaneously balancing grid- and demand-side objectives. The viability of the load control strategy is assessed through model-based simulations that explicitly track end-use functionality of responsive devices within a power systems analysis typically implemented to observe the effects of integrated wind energy systems. Results indicate that there is great potential for the proposed method to displace the need for increased reserve capacity in systems considering a high penetration of wind energy, thereby allowing conventional generation to operate more efficiently and avoid the need for possible capacity expansions.

Preoperative magnetic resonance imaging protocol for endoscopic cranial base image-guided surgery.

PubMed

Grindle, Christopher R; Curry, Joseph M; Kang, Melissa D; Evans, James J; Rosen, Marc R

2011-01-01

Despite the increasing utilization of image-guided surgery, no radiology protocols for obtaining magnetic resonance (MR) imaging of adequate quality are available in the current literature. At our institution, more than 300 endonasal cranial base procedures including pituitary, extended pituitary, and other anterior skullbase procedures have been performed in the past 3 years. To facilitate and optimize preoperative evaluation and assessment, there was a need to develop a magnetic resonance protocol. Retrospective Technical Assessment was performed. Through a collaborative effort between the otolaryngology, neurosurgery, and neuroradiology departments at our institution, a skull base MR image-guided (IGS) protocol was developed with several ends in mind. First, it was necessary to generate diagnostic images useful for the more frequently seen pathologies to improve work flow and limit the expense and inefficiency of case specific MR studies. Second, it was necessary to generate sequences useful for IGS, preferably using sequences that best highlight that lesion. Currently, at our institution, all MR images used for IGS are obtained using this protocol as part of preoperative planning. The protocol that has been developed allows for thin cut precontrast and postcontrast axial cuts that can be used to plan intraoperative image guidance. It also obtains a thin cut T2 axial series that can be compiled separately for intraoperative imaging, or may be fused with computed tomographic images for combined modality. The outlined protocol obtains image sequences effective for diagnostic and operative purposes for image-guided surgery using both T1 and T2 sequences. Copyright © 2011 Elsevier Inc. All rights reserved.

The Productivity and Technical Efficiency of Textile Industry Clusters in India

NASA Astrophysics Data System (ADS)

Bhaskaran, E.

2013-09-01

The Indian textile industry is one the largest and oldest sectors in the country and among the most important in the economy in terms of output, investment and employment (E). The sector employs nearly 35 million people and after agriculture, is the second-highest employer in the country. Its importance is underlined by the fact that it accounts for around 4 % of Gross Domestic Product, 14 % of industrial production, 9 % of excise collections, 18 % of E in the industrial sector, and 16 % of the country's total exports (Ex) earnings. For inclusive growth and sustainable development most of the Textile Manufacturers has adopted the Cluster Development Approach. The objective is to study the physical and financial performance, correlation, regression and Data Envelopment Analysis by measuring technical efficiency (Ø), peer weights (λi), input slacks (S-), output slacks (S+) and return to scale of four textile clusters (TCs) namely IchalKaranji Textile Cluster, Maharashtra; Ludhiana Textile Cluster, Punjab; Tirupur Textile Cluster, Tamilnadu and Panipat Textile Cluster, Haryana in India. The methodology adopted is using Data Envelopment Analysis of Output Oriented Banker Charnes Cooper Model by taking number of units (U) and number of E as inputs and sales (S) and Ex in crores as an outputs. The non-zero λi's represents the weights for efficient clusters. The S > 0 obtained for one TC reveals the excess U (S-) and E (S-) and shortage in sales (S+) and Ex (S+). To conclude, for inclusive growth and sustainable development, the inefficient TC should increase their S/turnover and Ex, as decrease in number of enterprises and E is practically not possible. Moreover for sustainable development, the TC should strengthen infrastructure interrelationships, technology interrelationships, procurement interrelationships, production interrelationships and marketing interrelationships to decrease cost, increase productivity and efficiency to compete in the world market.

Quality improvement utilizing in-situ simulation for a dual-hospital pediatric code response team.

PubMed

Yager, Phoebe; Collins, Corey; Blais, Carlene; O'Connor, Kathy; Donovan, Patricia; Martinez, Maureen; Cummings, Brian; Hartnick, Christopher; Noviski, Natan

2016-09-01

Given the rarity of in-hospital pediatric emergency events, identification of gaps and inefficiencies in the code response can be difficult. In-situ, simulation-based medical education programs can identify unrecognized systems-based challenges. We hypothesized that developing an in-situ, simulation-based pediatric emergency response program would identify latent inefficiencies in a complex, dual-hospital pediatric code response system and allow rapid intervention testing to improve performance before implementation at an institutional level. Pediatric leadership from two hospitals with a shared pediatric code response team employed the Institute for Healthcare Improvement's (IHI) Breakthrough Model for Collaborative Improvement to design a program consisting of Plan-Do-Study-Act cycles occurring in a simulated environment. The objectives of the program were to 1) identify inefficiencies in our pediatric code response; 2) correlate to current workflow; 3) employ an iterative process to test quality improvement interventions in a safe environment; and 4) measure performance before actual implementation at the institutional level. Twelve dual-hospital, in-situ, simulated, pediatric emergencies occurred over one year. The initial simulated event allowed identification of inefficiencies including delayed provider response, delayed initiation of cardiopulmonary resuscitation (CPR), and delayed vascular access. These gaps were linked to process issues including unreliable code pager activation, slow elevator response, and lack of responder familiarity with layout and contents of code cart. From first to last simulation with multiple simulated process improvements, code response time for secondary providers coming from the second hospital decreased from 29 to 7 min, time to CPR initiation decreased from 90 to 15 s, and vascular access obtainment decreased from 15 to 3 min. Some of these simulated process improvements were adopted into the institutional response while others continue to be trended over time for evidence that observed changes represent a true new state of control. Utilizing the IHI's Breakthrough Model, we developed a simulation-based program to 1) successfully identify gaps and inefficiencies in a complex, dual-hospital, pediatric code response system and 2) provide an environment in which to safely test quality improvement interventions before institutional dissemination. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Sault Tribe Building Efficiency Energy Audits

DOE Office of Scientific and Technical Information (OSTI.GOV)

Holt, Jeffrey W.

2013-09-26

The Sault Ste. Marie Tribe of Chippewa Indians is working to reduce energy consumption and expense in Tribally-owned governmental buildings. The Sault Ste. Marie Tribe of Chippewa Indians will conduct energy audits of nine Tribally-owned governmental buildings in three counties in the Upper Peninsula of Michigan to provide a basis for evaluating and selecting the technical and economic viability of energy efficiency improvement options. The Sault Ste. Marie Tribe of Chippewa Indians will follow established Tribal procurement policies and procedures to secure the services of a qualified provider to conduct energy audits of nine designated buildings. The contracted provider willmore » be required to provide a progress schedule to the Tribe prior to commencing the project and submit an updated schedule with their monthly billings. Findings and analysis reports will be required for buildings as completed, and a complete Energy Audit Summary Report will be required to be submitted with the provider?s final billing. Conducting energy audits of the nine governmental buildings will disclose building inefficiencies to prioritize and address, resulting in reduced energy consumption and expense. These savings will allow Tribal resources to be reallocated to direct services, which will benefit Tribal members and families.« less

The role of oil palm companies in Indonesia as a nation's competitive advantage

NASA Astrophysics Data System (ADS)

Tampubolon, N.; Pasaribu, M.

2017-09-01

Indonesia is the largest world Crude Palm Oil (CPO) producer with Malaysia in second place. This agricultural commodity has become a chief Indonesian foreign exchange earner behind fossil fuel exports. In 2016, the export value of this commodity reached USD 17.8 billion. Historically, Malaysia has been more advanced in the CPO delivery, which can be explained by the general companies’environment of management, technological advancement and engineering, human resource skills and superior external support, such as road infrastructure, regulations and research& development by the industry and government. It is clear from data that the Indonesian production is disadvantaged by a wide range of inefficiencies. They range from limited technology and production management skills to limitedcultivation advancement. Applications of technical improvements are desired to enhance the national competitive advantage to the next level. This paper is an exploration of the current management culture and to consider a strategic management model that would be the most appropriate for Indonesia and would enourage high end technology and plantation management. A gradual level improvement would enable Indonesia to compete on a global scale as an industry leader in the palm oil market.

Preclinical drug development.

PubMed

Brodniewicz, Teresa; Grynkiewicz, Grzegorz

2010-01-01

Life sciences provide reasonably sound prognosis for a number and nature of therapeutic targets on which drug design could be based, and search for new chemical entities--future new drugs, is now more than ever based on scientific principles. Nevertheless, current very long and incredibly costly drug discovery and development process is very inefficient, with attrition rate spanning from many thousands of new chemical structures, through a handful of validated drug leads, to single successful new drug launches, achieved in average after 13 years, with compounded cost estimates from hundreds of thousands to over one billion US dollars. Since radical pharmaceutical innovation is critically needed, number of new research projects concerning this area is steeply rising outside of big pharma industry--both in academic environment and in small private companies. Their prospective success will critically depend on project management, which requires combined knowledge of scientific, technical and legal matters, comprising regulations concerning admission of new drug candidates to be subjects of clinical studies. This paper attempts to explain basic rules and requirements of drug development within preclinical study period, in case of new chemical entities of natural or synthetic origin, which belong to low molecular weight category.

Assessment of multiple geophysical techniques for the characterization of municipal waste deposit sites

NASA Astrophysics Data System (ADS)

Gaël, Dumont; Tanguy, Robert; Nicolas, Marck; Frédéric, Nguyen

2017-10-01

In this study, we tested the ability of geophysical methods to characterize a large technical landfill installed in a former sand quarry. The geophysical surveys specifically aimed at delimitating the deposit site horizontal extension, at estimating its thickness and at characterizing the waste material composition (the moisture content in the present case). The site delimitation was conducted with electromagnetic (in-phase and out-of-phase) and magnetic (vertical gradient and total field) methods that clearly showed the transition between the waste deposit and the host formation. Regarding waste deposit thickness evaluation, electrical resistivity tomography appeared inefficient on this particularly thick deposit site. Thus, we propose a combination of horizontal to vertical noise spectral ratio (HVNSR) and multichannel analysis of the surface waves (MASW), which successfully determined the approximate waste deposit thickness in our test landfill. However, ERT appeared to be an appropriate tool to characterize the moisture content of the waste, which is of prior information for the organic waste biodegradation process. The global multi-scale and multi-method geophysical survey offers precious information for site rehabilitation studies, water content mitigation processes for enhanced biodegradation or landfill mining operation planning.

The Productivity Analysis of Chennai Automotive Industry Cluster

NASA Astrophysics Data System (ADS)

Bhaskaran, E.

2014-07-01

Chennai, also called the Detroit of India, is India's second fastest growing auto market and exports auto components and vehicles to US, Germany, Japan and Brazil. For inclusive growth and sustainable development, 250 auto component industries in Ambattur, Thirumalisai and Thirumudivakkam Industrial Estates located in Chennai have adopted the Cluster Development Approach called Automotive Component Cluster. The objective is to study the Value Chain, Correlation and Data Envelopment Analysis by determining technical efficiency, peer weights, input and output slacks of 100 auto component industries in three estates. The methodology adopted is using Data Envelopment Analysis of Output Oriented Banker Charnes Cooper model by taking net worth, fixed assets, employment as inputs and gross output as outputs. The non-zero represents the weights for efficient clusters. The higher slack obtained reveals the excess net worth, fixed assets, employment and shortage in gross output. To conclude, the variables are highly correlated and the inefficient industries should increase their gross output or decrease the fixed assets or employment. Moreover for sustainable development, the cluster should strengthen infrastructure, technology, procurement, production and marketing interrelationships to decrease costs and to increase productivity and efficiency to compete in the indigenous and export market.

Shale-oil-recovery systems incorporating ore beneficiation. Final report.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Weiss, M.A.; Klumpar, I.V.; Peterson, C.R.

This study analyzed the recovery of oil from oil shale by use of proposed systems which incorporate beneficiation of the shale ore (that is concentration of the kerogen before the oil-recovery step). The objective was to identify systems which could be more attractive than conventional surface retorting of ore. No experimental work was carried out. The systems analyzed consisted of beneficiation methods which could increase kerogen concentrations by at least four-fold. Potentially attractive low-enrichment methods such as density separation were not examined. The technical alternatives considered were bounded by the secondary crusher as input and raw shale oil as output.more » A sequence of ball milling, froth flotation, and retorting concentrate is not attractive for Western shales compared to conventional ore retorting; transporting the concentrate to another location for retorting reduces air emissions in the ore region but cost reduction is questionable. The high capital and energy cost s results largely from the ball milling step which is very inefficient. Major improvements in comminution seem achievable through research and such improvements, plus confirmation of other assumptions, could make high-enrichment beneficiation competitive with conventional processing. 27 figures, 23 tables.« less

Silica ecosystem for synergistic biotransformation

NASA Astrophysics Data System (ADS)

Mutlu, Baris R.; Sakkos, Jonathan K.; Yeom, Sujin; Wackett, Lawrence P.; Aksan, Alptekin

2016-06-01

Synergistical bacterial species can perform more varied and complex transformations of chemical substances than either species alone, but this is rarely used commercially because of technical difficulties in maintaining mixed cultures. Typical problems with mixed cultures on scale are unrestrained growth of one bacterium, which leads to suboptimal population ratios, and lack of control over bacterial spatial distribution, which leads to inefficient substrate transport. To address these issues, we designed and produced a synthetic ecosystem by co-encapsulation in a silica gel matrix, which enabled precise control of the microbial populations and their microenvironment. As a case study, two greatly different microorganisms: Pseudomonas sp. NCIB 9816 and Synechococcus elongatus PCC 7942 were encapsulated. NCIB 9816 can aerobically biotransform over 100 aromatic hydrocarbons, a feat useful for synthesis of higher value commodity chemicals or environmental remediation. In our system, NCIB 9816 was used for biotransformation of naphthalene (a model substrate) into CO2 and the cyanobacterium PCC 7942 was used to provide the necessary oxygen for the biotransformation reactions via photosynthesis. A mathematical model was constructed to determine the critical cell density parameter to maximize oxygen production, and was then used to maximize the biotransformation rate of the system.

Silica ecosystem for synergistic biotransformation

PubMed Central

Mutlu, Baris R.; Sakkos, Jonathan K.; Yeom, Sujin; Wackett, Lawrence P.; Aksan, Alptekin

2016-01-01

Synergistical bacterial species can perform more varied and complex transformations of chemical substances than either species alone, but this is rarely used commercially because of technical difficulties in maintaining mixed cultures. Typical problems with mixed cultures on scale are unrestrained growth of one bacterium, which leads to suboptimal population ratios, and lack of control over bacterial spatial distribution, which leads to inefficient substrate transport. To address these issues, we designed and produced a synthetic ecosystem by co-encapsulation in a silica gel matrix, which enabled precise control of the microbial populations and their microenvironment. As a case study, two greatly different microorganisms: Pseudomonas sp. NCIB 9816 and Synechococcus elongatus PCC 7942 were encapsulated. NCIB 9816 can aerobically biotransform over 100 aromatic hydrocarbons, a feat useful for synthesis of higher value commodity chemicals or environmental remediation. In our system, NCIB 9816 was used for biotransformation of naphthalene (a model substrate) into CO2 and the cyanobacterium PCC 7942 was used to provide the necessary oxygen for the biotransformation reactions via photosynthesis. A mathematical model was constructed to determine the critical cell density parameter to maximize oxygen production, and was then used to maximize the biotransformation rate of the system. PMID:27264916

Review: Water recovery from brines and salt-saturated solutions: operability and thermodynamic efficiency considerations for desalination technologies

PubMed Central

Vane, Leland M.

2017-01-01

BACKGROUND When water is recovered from a saline source, a brine concentrate stream is produced. Management of the brine stream can be problematic, particularly in inland regions. An alternative to brine disposal is recovery of water and possibly salts from the concentrate. RESULTS This review provides an overview of desalination technologies and discusses the thermodynamic efficiencies and operational issues associated with the various technologies particularly with regard to high salinity streams. CONCLUSION Due to the high osmotic pressures of the brine concentrates, reverse osmosis, the most common desalination technology, is impractical. Mechanical vapor compression which, like reverse osmosis, utilizes mechanical work to operate, is reported to have the highest thermodynamic efficiency of the desalination technologies for treatment of salt-saturated brines. Thermally-driven processes, such as flash evaporation and distillation, are technically able to process saturated salt solutions, but suffer from low thermodynamic efficiencies. This inefficiency could be offset if an inexpensive source of waste or renewable heat could be used. Overarching issues posed by high salinity solutions include corrosion and the formation of scales/precipitates. These issues limit the materials, conditions, and unit operation designs that can be used. PMID:29225395

Utilities and manufacturers: Pioneering partnerships and their lessons for the 21st century

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bartsch, C.; DeVaul, D.

1994-12-31

Manufacturers who, in partnership with utilities, improved their production process through energy efficiency and waste minimization strategies are discussed. Frequently these investments changed the corporate culture and resulted in a commitment to continuous improvement that may ensure the industrialists adapt to a rapidly evolving marketplace. The Northeast-Midwest Institute`s work to record these case studies developed out of the observation that older manufacturing facilities too often are run until no longer competitive, then closed, and new plants are built somewhere else - increasingly overseas. Unemployment, poverty, and cycles of economic and social deterioration too often follow if a new economic basemore » cannot be created. At the same time, inefficient industrial plants tend to emit large quantities of waste materials; industry produces more than 600 million tons of hazardous wastes and approximately 13 billion tons of solid wastes each year. To help identify how to avoid such pitfalls, the Institute sought out manufacturers who modernized successfully. Case studies are presented that show that utilities often are instrumental in catalyzing change in their industrial partners. In fact, much can be gained from utilities and industries working together. Many manufacturers need technical and financial assistance to maintain peak productivity.« less

Review: Water recovery from brines and salt-saturated solutions: operability and thermodynamic efficiency considerations for desalination technologies.

PubMed

Vane, Leland M

2017-03-08

When water is recovered from a saline source, a brine concentrate stream is produced. Management of the brine stream can be problematic, particularly in inland regions. An alternative to brine disposal is recovery of water and possibly salts from the concentrate. This review provides an overview of desalination technologies and discusses the thermodynamic efficiencies and operational issues associated with the various technologies particularly with regard to high salinity streams. Due to the high osmotic pressures of the brine concentrates, reverse osmosis, the most common desalination technology, is impractical. Mechanical vapor compression which, like reverse osmosis, utilizes mechanical work to operate, is reported to have the highest thermodynamic efficiency of the desalination technologies for treatment of salt-saturated brines. Thermally-driven processes, such as flash evaporation and distillation, are technically able to process saturated salt solutions, but suffer from low thermodynamic efficiencies. This inefficiency could be offset if an inexpensive source of waste or renewable heat could be used. Overarching issues posed by high salinity solutions include corrosion and the formation of scales/precipitates. These issues limit the materials, conditions, and unit operation designs that can be used.

Solid waste management in Kolkata, India: practices and challenges.

PubMed

Hazra, Tumpa; Goel, Sudha

2009-01-01

This paper presents an overview of current solid waste management (SWM) practices in Kolkata, India and suggests solutions to some of the major problems. More than 2920ton/d of solid waste are generated in the Kolkata Municipal Corporation (KMC) area and the budget allocation for 2007-2008 was Rs. 1590 million (US$40 million), which amounts to Rs. 265/cap-y (US$6.7/cap-d) on SWM. This expenditure is insufficient to provide adequate SWM services. Major deficiencies were found in all elements of SWM. Despite 70% of the SWM budget being allocated for collection, collection efficiency is around 60-70% for the registered residents and less than 20% for unregistered residents (slum dwellers). The collection process is deficient in terms of manpower and vehicle availability. Bin capacity provided is adequate but locations were found to be inappropriate, thus contributing to the inefficiency of the system. At this time, no treatment is provided to the waste and waste is dumped on open land at Dhapa after collection. Lack of suitable facilities (equipment and infrastructure) and underestimates of waste generation rates, inadequate management and technical skills, improper bin collection, and route planning are responsible for poor collection and transportation of municipal solid wastes.

Acoustic measurement and morphological features of organic sediment deposits in combined sewer networks.

PubMed

Carnacina, Iacopo; Larrarte, Frédérique; Leonardi, Nicoletta

2017-04-01

The performance of sewer networks has important consequences from an environmental and social point of view. Poor functioning can result in flood risk and pollution at a large scale. Sediment deposits forming in sewer trunks might severely compromise the sewer line by affecting the flow field, reducing cross-sectional areas, and increasing roughness coefficients. In spite of numerous efforts, the morphological features of these depositional environments remain poorly understood. The interface between water and sediment remains inefficiently identified and the estimation of the stock of deposit is frequently inaccurate. In part, this is due to technical issues connected to difficulties in collecting accurate field measurements without disrupting existing morphologies. In this paper, results from an extensive field campaign are presented; during the campaign a new survey methodology based on acoustic techniques has been tested. Furthermore, a new algorithm for the detection of the soil-water interface, and therefore for the correct esteem of sediment stocks is proposed. Finally, results in regard to bed topography, and morphological features at two different field sites are presented and reveal that a large variability in bed forms is present along sewer networks. Copyright © 2017 Elsevier Ltd. All rights reserved.

Using the critical incident technique to define a minimal data set for requirements elicitation in public health.

PubMed

Olvingson, Christina; Hallberg, Niklas; Timpka, Toomas; Greenes, Robert A

2002-12-18

The introduction of computer-based information systems (ISs) in public health provides enhanced possibilities for service improvements and hence also for improvement of the population's health. Not least, new communication systems can help in the socialization and integration process needed between the different professions and geographical regions. Therefore, development of ISs that truly support public health practices require that technical, cognitive, and social issues be taken into consideration. A notable problem is to capture 'voices' of all potential users, i.e., the viewpoints of different public health practitioners. Failing to capture these voices will result in inefficient or even useless systems. The aim of this study is to develop a minimal data set for capturing users' voices on problems experienced by public health professionals in their daily work and opinions about how these problems can be solved. The issues of concern thus captured can be used both as the basis for formulating the requirements of ISs for public health professionals and to create an understanding of the use context. Further, the data can help in directing the design to the features most important for the users.

The French Health Care System; What can We Learn?

PubMed

El Taguri, A; Nasef, A

2008-12-01

All public systems look for the best organizational structure to funnel part of their national income into healthcare services. Appropriate policies may differ widely across country settings. Most healthcare systems fall under one of two broad categories, either Bismark or Beveridge systems. There is no simple ideal model for the organization of health services, but most healthcare systems that follow the Beveridge healthcare model are poor performers. The Libyan Health system is a low responsive, inefficient and underperforming system that lacks goals and/or SMART. (Specific, Measurable, Achievable, Realistic, Time specific) objectives. A look at different organization models in the world would reinforce efforts to reorganize and improve the performance of the Libyan National Healthcare services. The French Health Care System (FHCS) ranked first according to the WHO and the European Health Consumer Powerhouse. The FHCS was described to have a technically efficient, generous healthcare system that provides the best overall health care. This makes the FHCS a practical model of organization having many of the essential aspects of a modern national health service. In this review, we describe the main features of the FHCS, current challenges and future trends with particular attention paid to aspects that could be of importance to the Libyan Healthcare System.

Tactical Approaches for Trading Science Objectives Against Measurements and Mission Design: Science Traceability Techniques at the Jet Propulsion Laboratory

NASA Astrophysics Data System (ADS)

Nash, A. E., III

2017-12-01

The most common approaches to identifying the most effective mission design to maximize science return from a potential set of competing alternative design approaches are often inefficient and inaccurate. Recently, Team-X at the Jet Propulsion Laboratory undertook an effort to improve both the speed and quality of science - measurement - mission design trade studies. We will report on the methodology & processes employed and their effectiveness in trade study speed and quality. Our results indicate that facilitated subject matter expert peers are the keys to speed and quality improvements in the effectiveness of science - measurement - mission design trade studies.

The Productivity Costs of Inefficient Hiring Practices: Evidence from Late Teacher Hiring

PubMed Central

Papay, John P.; Kraft, Matthew A.

2017-01-01

We use matched employee-employer records from the teacher labor market to explore the effects of late teacher hiring on student achievement. Hiring teachers after the school year starts reduces student achievement by 0.042SD in mathematics and 0.026SD in reading. This reflects, in part, a temporary disruption effect in the first year. In mathematics, but not in reading, late-hired teachers remain persistently less effective, evidence of negative selection in the teacher labor market. Late hiring concentrates in schools that disproportionately serve disadvantaged student populations, contributing to challenges in ensuring an equitable distribution of educational resources across students. PMID:28966429

The Productivity Costs of Inefficient Hiring Practices: Evidence from Late Teacher Hiring.

PubMed

Papay, John P; Kraft, Matthew A

2016-01-01

We use matched employee-employer records from the teacher labor market to explore the effects of late teacher hiring on student achievement. Hiring teachers after the school year starts reduces student achievement by 0.042SD in mathematics and 0.026SD in reading. This reflects, in part, a temporary disruption effect in the first year. In mathematics, but not in reading, late-hired teachers remain persistently less effective, evidence of negative selection in the teacher labor market. Late hiring concentrates in schools that disproportionately serve disadvantaged student populations, contributing to challenges in ensuring an equitable distribution of educational resources across students.

An Archival Research Comparing Learning Effectiveness and Training Transfer Perceptions between Classroom Technical Training and Synchronous Online Technical Training

ERIC Educational Resources Information Center

Jordan, Charles L.

2016-01-01

Synchronous online training has become one of the preferred training modes for organizations. Despite organizations increasing their use of online training, there is still little data to confirm that synchronous online technical training is as effective as classroom technical training for training transfer. Although learning effectiveness between…

Novel Listeria Vectors Secreting Gut Flora Altering Agents to Prevent Colon Cancer and Treat Colitis

DTIC Science & Technology

2016-09-01

L1 KO cell line using CRISPR to optimize library screening for anti-B7-H1 scFv. We collected useful data on immune and signaling events in colon...down B7-H1 in the B16F10 line for screening, but this was also inefficient. We then used CRISPR /Cas9 to effect a total KO of B7-H1 in the B16F10 cell

Budget Issues: Effective Oversight and Budget Discipline Are Essential--Even in a Time of Surplus

DTIC Science & Technology

2000-02-01

substantial benefit from USDA’s food safety inspection and testing services.18 In 1997, the Congress created Medicare+Choice to encourage wider availability...quality of the nation’s food is inefficient and outdated. Within USDA, the Food Safety and Inspection Service (FSIS) is responsible for the safety of...FDA, and 10 other federal agencies administer over 35 different laws that oversee food safety . The current food safety system suffers from

ARACNe-AP: Gene Network Reverse Engineering through Adaptive Partitioning inference of Mutual Information. | Office of Cancer Genomics

Cancer.gov

The accurate reconstruction of gene regulatory networks from large scale molecular profile datasets represents one of the grand challenges of Systems Biology. The Algorithm for the Reconstruction of Accurate Cellular Networks (ARACNe) represents one of the most effective tools to accomplish this goal. However, the initial Fixed Bandwidth (FB) implementation is both inefficient and unable to deal with sample sets providing largely uneven coverage of the probability density space.

Operating room metrics score card-creating a prototype for individualized feedback.

PubMed

Gabriel, Rodney A; Gimlich, Robert; Ehrenfeld, Jesse M; Urman, Richard D

2014-11-01

The balance between reducing costs and inefficiencies with that of patient safety is a challenging problem faced in the operating room suite. An ongoing challenge is the creation of effective strategies that reduce these inefficiencies and provide real-time personalized metrics and electronic feedback to anesthesia practitioners. We created a sample report card structure, utilizing existing informatics systems. This system allows to gather and analyze operating room metrics for each anesthesia provider and offer personalized feedback. To accomplish this task, we identified key metrics that represented time and quality parameters. We collected these data for individual anesthesiologists and compared performance to the overall group average. Data were presented as an electronic score card and made available to individual clinicians on a real-time basis in an effort to provide effective feedback. These metrics included number of cancelled cases, average turnover time, average time to operating room ready and patient in room, number of delayed first case starts, average induction time, average extubation time, average time to recovery room arrival to discharge, performance feedback from other providers, compliance to various protocols, and total anesthetic costs. The concept we propose can easily be generalized to a variety of operating room settings, types of facilities and OR health care professionals. Such a scorecard can be created using content that is important for operating room efficiency, research, and practice improvement for anesthesia providers.

Set shifting in children and adolescents with anorexia nervosa: an exploratory systematic review and meta-analysis.

PubMed

Lang, Katie; Stahl, Daniel; Espie, Jonathan; Treasure, Janet; Tchanturia, Kate

2014-05-01

Set shifting inefficiencies in adults with anorexia nervosa (AN) are established, however the neurocognitive profile of children and adolescents with AN is less clear. This study aimed to provide a review of the literature. Electronic databases were used to search for manuscripts. Meta-analysis was performed on seven studies using two neuropsychological tests (Trail Making Task, TMT; Wisconsin Card Sorting Task, WCST). The mean difference in outcome between AN and healthy control (HC) groups was standardized by calculating Cohen's d. Meta-analysis of TMT studies showed a nonsignificant negative, pooled standardized mean difference of -0.005 (95% C.I. -0.416 to 0.406, z = 0.02, p = .98). WCST studies revealed a nonsignificant pooled effect size of d = 0.196 (95% C.I. -0.091-0.483, z = 1.34, p = .18). Studies which did not allow for a calculation of effect size typically showed a nonsignificant, worse performance by the AN groups. The inefficiencies in set shifting that are apparent in the adult AN literature do not appear to be as pronounced in children. This may suggest that set shifting difficulties in adult AN are the result of starvation or indicative of longer duration of illness. Larger studies are needed to confirm these impressions. Copyright © 2013 Wiley Periodicals, Inc.

ESTIMATING TREATMENT EFFECTS ON HEALTHCARE COSTS UNDER EXOGENEITY: IS THERE A ‘MAGIC BULLET’?

PubMed Central

Polsky, Daniel; Manning, Willard G.

2011-01-01

Methods for estimating average treatment effects, under the assumption of no unmeasured confounders, include regression models; propensity score adjustments using stratification, weighting, or matching; and doubly robust estimators (a combination of both). Researchers continue to debate about the best estimator for outcomes such as health care cost data, as they are usually characterized by an asymmetric distribution and heterogeneous treatment effects,. Challenges in finding the right specifications for regression models are well documented in the literature. Propensity score estimators are proposed as alternatives to overcoming these challenges. Using simulations, we find that in moderate size samples (n= 5000), balancing on propensity scores that are estimated from saturated specifications can balance the covariate means across treatment arms but fails to balance higher-order moments and covariances amongst covariates. Therefore, unlike regression model, even if a formal model for outcomes is not required, propensity score estimators can be inefficient at best and biased at worst for health care cost data. Our simulation study, designed to take a ‘proof by contradiction’ approach, proves that no one estimator can be considered the best under all data generating processes for outcomes such as costs. The inverse-propensity weighted estimator is most likely to be unbiased under alternate data generating processes but is prone to bias under misspecification of the propensity score model and is inefficient compared to an unbiased regression estimator. Our results show that there are no ‘magic bullets’ when it comes to estimating treatment effects in health care costs. Care should be taken before naively applying any one estimator to estimate average treatment effects in these data. We illustrate the performance of alternative methods in a cost dataset on breast cancer treatment. PMID:22199462

Effect of fertility on the economics of pasture-based dairy systems.

PubMed

Shalloo, L; Cromie, A; McHugh, N

2014-05-01

There are significant costs associated with reproductive inefficiency in pasture-based dairy herds. This study has quantified the economic effect of a number of key variables associated with reproductive inefficiency in a dairy herd and related them to 6-week calving rate for both cows and heifers. These variables include: increased culling costs, the effects of sub optimum calving dates, increased labour costs and increased artificial insemination (AI) and intervention costs. The Moorepark Dairy Systems Model which is a stochastic budgetary simulation model was used to simulate the overall economic effect at farm level. The effect of change in each of the components was simulated in the model and the costs associated with each component was quantified. An analysis of national data across a 4-year period using the Irish Cattle Breeding Federation database was used to quantify the relationship between the 6-week calving rate of a herd with survivability (%), calving interval (days) and the level of AI usage. The costs associated with increased culling (%), calving date slippage (day), increased AI and intervention costs (0.1 additional inseminations), as well as, increased labour costs (10%) were quantified as €13.68, €3.86, €4.56 and €29.6/cow per year. There was a statistically significant association between the 6-week calving rate and survivability, calving interval and AI usage at farm level. A 1% change in 6-week calving rate was associated with €9.26/cow per annum for cows and €3.51/heifer per annum for heifers. This study does not include the indirect costs such as reduced potential for expansion, increased costs associated with failing to maintain a closed herd as well as the unrealised potential within the herd.

An investigation of Forex market efficiency based on detrended fluctuation analysis: A case study for Iran

NASA Astrophysics Data System (ADS)

Abounoori, Esmaiel; Shahrazi, Mahdi; Rasekhi, Saeed

2012-06-01

The efficient market hypothesis (EMH) states that asset prices fully reflect all available information. As a result, speculators cannot predict the future behavior of asset prices and earn excess profits at least after adjusting for risk. Although initial tests of the EMH were performed on stock market data, the EMH was soon applied to other markets including foreign exchange (FX). This study uses the detrended fluctuation analysis (DFA) technique to test 01:12:2005-18:04:2010 Iranian Rial/US Dollar exchange rate time series data to see if it can be explained by the weak form of the EMH. Moreover, to determine changes in the degree of inefficiency over time, the whole period has been divided into four subperiods. The study shows that the Iranian Forex market (the Rial/Dollar case) is weak-form inefficient over the whole period and in each of the subperiods. However, the degree of inefficiency is not constant over time. The findings suggest that profitable risk-adjusted trades could be made using past data.

Determinants of Regional Variation in Health Expenditures in Germany.

PubMed

Göpffarth, Dirk; Kopetsch, Thomas; Schmitz, Hendrik

2016-07-01

Health care expenditure in Germany shows clear regional differences. Such geographic variations are often seen as an indicator for inefficiency. With its homogeneous health care system, low co-payments and uniform prices, Germany is a particularly suited example to analyse regional variations. We use data for the year 2011 on expenditure, utilization of health services and state of health in Germany's statutory health insurance system. This data, which originate from a variety of administrative sources and cover about 90% of the population, are enriched with a wealth of socio-economic variables, data on pollutants, prices and individual preferences. State of health and demography explains 55% of the differences as measured by the standard deviation while all control variables account for a total of 72% of the differences at county level. With other measures of variation, we can account for an even greater proportion. A higher proportion of variation than usually supposed can thus be explained. Whilst this study cannot quantify inefficiencies, our results contradict the thesis that regional variations reflect inefficiency. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Pediatric Trauma Transfer Imaging Inefficiencies-Opportunities for Improvement with Cloud Technology.

PubMed

Puckett, Yana; To, Alvin

2016-01-01

This study examines the inefficiencies of radiologic imaging transfers from one hospital to the other during pediatric trauma transfers in an era of cloud based information sharing. Retrospective review of all patients transferred to a pediatric trauma center from 2008-2014 was performed. Imaging was reviewed for whether imaging accompanied the patient, whether imaging was able to be uploaded onto computer for records, whether imaging had to be repeated, and whether imaging obtained at outside hospitals (OSH) was done per universal pediatric trauma guidelines. Of the 1761 patients retrospectively reviewed, 559 met our inclusion criteria. Imaging was sent with the patient 87.7% of the time. Imaging was unable to be uploaded 31.9% of the time. CT imaging had to be repeated 1.8% of the time. CT scan was not done per universal pediatric trauma guidelines 1.2% of the time. Our study demonstrated that current imaging transfer is inefficient, leads to excess ionizing radiation, and increased healthcare costs. Universal implementation of cloud based radiology has the potential to eliminate excess ionizing radiation to children, improve patient care, and save cost to healthcare system.

Dairy farm cost efficiency.

PubMed

Tauer, L W; Mishra, A K

2006-12-01

A stochastic cost equation was estimated for US dairy farms using national data from the production year 2000 to determine how farmers might reduce their cost of production. Cost of producing a unit of milk was estimated into separate frontier (efficient) and inefficiency components, with both components estimated as a function of management and causation variables. Variables were entered as impacting the frontier component as well as the efficiency component of the stochastic curve because a priori both components could be impacted. A factor that has an impact on the cost frontier was the number of hours per day the milking facility is used. Using the milking facility for more hours per day decreased frontier costs; however, inefficiency increased with increased hours of milking facility use. Thus, farmers can decrease costs with increased utilization of the milking facility, but only if they are efficient in this strategy. Parlors compared with stanchions used for milking did not decrease frontier costs, but decreased costs because of increased efficiency, as did the use of a nutritionist. Use of rotational grazing decreased frontier costs but also increased inefficiency. Older farmers were less efficient.

Bootstrapping data envelopment analysis of efficiency and productivity of county public hospitals in Eastern, Central, and Western China after the public hospital reform.

PubMed

Wang, Man-Li; Fang, Hai-Qing; Tao, Hong-Bing; Cheng, Zhao-Hui; Lin, Xiao-Jun; Cai, Miao; Xu, Chang; Jiang, Shuai

2017-10-01

China implemented the public hospital reform in 2012. This study utilized bootstrapping data envelopment analysis (DEA) to evaluate the technical efficiency (TE) and productivity of county public hospitals in Eastern, Central, and Western China after the 2012 public hospital reform. Data from 127 county public hospitals (39, 45, and 43 in Eastern, Central, and Western China, respectively) were collected during 2012-2015. Changes of TE and productivity over time were estimated by bootstrapping DEA and bootstrapping Malmquist. The disparities in TE and productivity among public hospitals in the three regions of China were compared by Kruskal-Wallis H test and Mann-Whitney U test. The average bias-corrected TE values for the four-year period were 0.6442, 0.5785, 0.6099, and 0.6094 in Eastern, Central, and Western China, and the entire country respectively, with average non-technical efficiency, low pure technical efficiency (PTE), and high scale efficiency found. Productivity increased by 8.12%, 0.25%, 12.11%, and 11.58% in China and its three regions during 2012-2015, and such increase in productivity resulted from progressive technological changes by 16.42%, 6.32%, 21.08%, and 21.42%, respectively. The TE and PTE of the county hospitals significantly differed among the three regions of China. Eastern and Western China showed significantly higher TE and PTE than Central China. More than 60% of county public hospitals in China and its three areas operated at decreasing return scales. There was a considerable space for TE improvement in county hospitals in China and its three regions. During 2012-2015, the hospitals experienced progressive productivity; however, the PTE changed adversely. Moreover, Central China continuously achieved a significantly lower efficiency score than Eastern and Western China. Decision makers and administrators in China should identify the causes of the observed inefficiencies and take appropriate measures to increase the efficiency of county public hospitals in the three areas of China, especially in Central China.

Effects of substrate network topologies on competition dynamics

NASA Astrophysics Data System (ADS)

Lee, Sang Hoon; Jeong, Hawoong

2006-08-01

We study a competition dynamics, based on the minority game, endowed with various substrate network structures. We observe the effects of the network topologies by investigating the volatility of the system and the structure of follower networks. The topology of substrate structures significantly influences the system efficiency represented by the volatility and such substrate networks are shown to amplify the herding effect and cause inefficiency in most cases. The follower networks emerging from the leadership structure show a power-law incoming degree distribution. This study shows the emergence of scale-free structures of leadership in the minority game and the effects of the interaction among players on the networked version of the game.

An approach to holistically assess (dairy) farm eco-efficiency by combining Life Cycle Analysis with Data Envelopment Analysis models and methodologies.

PubMed

Soteriades, A D; Faverdin, P; Moreau, S; Charroin, T; Blanchard, M; Stott, A W

2016-11-01

Eco-efficiency is a useful guide to dairy farm sustainability analysis aimed at increasing output (physical or value added) and minimizing environmental impacts (EIs). Widely used partial eco-efficiency ratios (EIs per some functional unit, e.g. kg milk) can be problematic because (i) substitution possibilities between EIs are ignored, (ii) multiple ratios can complicate decision making and (iii) EIs are not usually associated with just the functional unit in the ratio's denominator. The objective of this study was to demonstrate a 'global' eco-efficiency modelling framework dealing with issues (i) to (iii) by combining Life Cycle Analysis (LCA) data and the multiple-input, multiple-output production efficiency method Data Envelopment Analysis (DEA). With DEA each dairy farm's outputs and LCA-derived EIs are aggregated into a single, relative, bounded, dimensionless eco-efficiency score, thus overcoming issues (i) to (iii). A novelty of this study is that a model providing a number of additional desirable properties was employed, known as the Range Adjusted Measure (RAM) of inefficiency. These properties altogether make RAM advantageous over other DEA models and are as follows. First, RAM is able to simultaneously minimize EIs and maximize outputs. Second, it indicates which EIs and/or outputs contribute the most to a farm's eco-inefficiency. Third it can be used to rank farms in terms of eco-efficiency scores. Thus, non-parametric rank tests can be employed to test for significant differences in terms of eco-efficiency score ranks between different farm groups. An additional DEA methodology was employed to 'correct' the farms' eco-efficiency scores for inefficiencies attributed to managerial factors. By removing managerial inefficiencies it was possible to detect differences in eco-efficiency between farms solely attributed to uncontrollable factors such as region. Such analysis is lacking in previous dairy studies combining LCA with DEA. RAM and the 'corrective' methodology were demonstrated with LCA data from French specialized dairy farms grouped by region (West France, Continental France) and feeding strategy (regardless of region). Mean eco-efficiency score ranks were significantly higher for farms with 30% maize in the total forage area before correcting for managerial inefficiencies. Mean eco-efficiency score ranks were higher for West than Continental farms, but significantly higher only after correcting for managerial inefficiencies. These results helped identify the eco-efficiency potential of each region and feeding strategy and could therefore aid advisors and policy makers at farm or region/sector level. The proposed framework helped better measure and understand (dairy) farm eco-efficiency, both within and between different farm groups.

The Hsk1(Cdc7) Replication Kinase Regulates Origin Efficiency

PubMed Central

Patel, Prasanta K.; Kommajosyula, Naveen; Rosebrock, Adam; Bensimon, Aaron; Leatherwood, Janet; Bechhoefer, John

2008-01-01

Origins of DNA replication are generally inefficient, with most firing in fewer than half of cell cycles. However, neither the mechanism nor the importance of the regulation of origin efficiency is clear. In fission yeast, origin firing is stochastic, leading us to hypothesize that origin inefficiency and stochasticity are the result of a diffusible, rate-limiting activator. We show that the Hsk1-Dfp1 replication kinase (the fission yeast Cdc7-Dbf4 homologue) plays such a role. Increasing or decreasing Hsk1-Dfp1 levels correspondingly increases or decreases origin efficiency. Furthermore, tethering Hsk1-Dfp1 near an origin increases the efficiency of that origin, suggesting that the effective local concentration of Hsk1-Dfp1 regulates origin firing. Using photobleaching, we show that Hsk1-Dfp1 is freely diffusible in the nucleus. These results support a model in which the accessibility of replication origins to Hsk1-Dfp1 regulates origin efficiency and provides a potential mechanistic link between chromatin structure and replication timing. By manipulating Hsk1-Dfp1 levels, we show that increasing or decreasing origin firing rates leads to an increase in genomic instability, demonstrating the biological importance of appropriate origin efficiency. PMID:18799612

Further evidence of auditory extinction in aphasia.

PubMed

Marshall, Rebecca Shisler; Basilakos, Alexandra; Love-Myers, Kim

2013-02-01

Preliminary research (Shisler, 2005) suggests that auditory extinction in individuals with aphasia (IWA) may be connected to binding and attention. In this study, the authors expanded on previous findings on auditory extinction to determine the source of extinction deficits in IWA. Seventeen IWA (M(age) = 53.19 years) and 17 neurologically intact controls (M(age) = 55.18 years) participated. Auditory stimuli were spoken letters presented in a free-field listening environment. Stimuli were presented in single-stimulus stimulation (SSS) or double-simultaneous stimulation (DSS) trials across 5 conditions designed to determine whether extinction is related to binding, inefficient attention resource allocation, or overall deficits in attention. All participants completed all experimental conditions. Significant extinction was demonstrated only by IWA when sounds were different, providing further evidence of auditory extinction. However, binding requirements did not appear to influence the IWA's performance. Results indicate that, for IWA, auditory extinction may not be attributed to a binding deficit or inefficient attention resource allocation because of equivalent performance across all 5 conditions. Rather, overall attentional resources may be influential. Future research in aphasia should explore the effect of the stimulus presentation in addition to the continued study of attention treatment.

Experimental study of the effect of cycle pressure on lean combustion emissions

NASA Technical Reports Server (NTRS)

Roffe, G.; Venkataramani, K. S.

1978-01-01

Experiments were conducted in which a stream of premixed propane and air was burned under conditions representative of gas turbine operation. Emissions of NOx, CO, and unburned hydrocarbons (UHC) were measured over a range of combustor inlet temperature, pressure, and residence time at equivalence ratios from 0.7 down to the lean stability limit. At an inlet temperature of 600 K, observed NOx levels dropped markedly with decreasing pressure for pressures below 20 atm. The NOx levels are proportional to combustor residence time and formation rates were principally a function of adiabatic flame temperature. For adiabatic flame temperatures of 2050 K and higher, CO reached chemical equilibrium within 2 msec. Unburned hydrocarbon species dropped to a negligible level within 2 msec regardless of inlet temperature, pressure, or equivalence ratio. For a combustor residence time of 2.5 msec, combustion inefficiency became less than 0.01% at an adiabatic flame temperature of 2050 K. The maximum combustion inefficiency observed was on the order of 1% and corresponded to conditions near the lean stability limit. Using a perforated plate flameholder, this limit is well represented by the condition of 1800 K adiabatic flame temperature.

B cell depleting therapy regulates splenic and circulating T follicular helper cells in immune thrombocytopenia.

PubMed

Audia, Sylvain; Rossato, Marzia; Trad, Malika; Samson, Maxime; Santegoets, Kim; Gautheron, Alexandrine; Bekker, Cornelis; Facy, Olivier; Cheynel, Nicolas; Ortega-Deballon, Pablo; Boulin, Mathieu; Berthier, Sabine; Leguy-Seguin, Vanessa; Martin, Laurent; Ciudad, Marion; Janikashvili, Nona; Saas, Philippe; Radstake, Timothy; Bonnotte, Bernard

2017-02-01

B cells are involved in immune thrombocytopenia (ITP) pathophysiology by producing antiplatelet auto-antibodies. However more than a half of ITP patients do not respond to B cell depletion induced by rituximab (RTX). The persistence of splenic T follicular helper cells (TFH) that we demonstrated to be expanded during ITP and to support B cell differentiation and antiplatelet antibody-production may participate to RTX inefficiency. Whereas it is well established that the survival of TFH depends on B cells in animal models, nothing is known in humans yet. To determine the effect of B cell depletion on human TFH, we quantified B cells and TFH in the spleen and in the blood from ITP patients treated or not with RTX. We showed that B cell depletion led to a dramatic decrease in splenic TFH and in CXCL13 and IL-21, two cytokines predominantly produced by TFH. The absolute count of circulating TFH and serum CXCL13 also decreased after RTX treatment, whatever the therapeutic response. Therefore, we showed that the maintenance of TFH required B cells and that TFH are not involved in the inefficiency of RTX in ITP. Copyright © 2016 Elsevier Ltd. All rights reserved.

Visual search in divided areas: dividers initially interfere with and later facilitate visual search.

PubMed

Nakashima, Ryoichi; Yokosawa, Kazuhiko

2013-02-01

A common search paradigm requires observers to search for a target among undivided spatial arrays of many items. Yet our visual environment is populated with items that are typically arranged within smaller (subdivided) spatial areas outlined by dividers (e.g., frames). It remains unclear how dividers impact visual search performance. In this study, we manipulated the presence and absence of frames and the number of frames subdividing search displays. Observers searched for a target O among Cs, a typically inefficient search task, and for a target C among Os, a typically efficient search. The results indicated that the presence of divider frames in a search display initially interferes with visual search tasks when targets are quickly detected (i.e., efficient search), leading to early interference; conversely, frames later facilitate visual search in tasks in which targets take longer to detect (i.e., inefficient search), leading to late facilitation. Such interference and facilitation appear only for conditions with a specific number of frames. Relative to previous studies of grouping (due to item proximity or similarity), these findings suggest that frame enclosures of multiple items may induce a grouping effect that influences search performance.

Appointment reminder systems are effective but not optimal: results of a systematic review and evidence synthesis employing realist principles

PubMed Central

McLean, Sionnadh Mairi; Booth, Andrew; Gee, Melanie; Salway, Sarah; Cobb, Mark; Bhanbhro, Sadiq; Nancarrow, Susan A

2016-01-01

Missed appointments are an avoidable cost and resource inefficiency which impact upon the health of the patient and treatment outcomes. Health care services are increasingly utilizing reminder systems to manage these negative effects. This study explores the effectiveness of reminder systems for promoting attendance, cancellations, and rescheduling of appointments across all health care settings and for particular patient groups and the contextual factors which indicate that reminders are being employed sub-optimally. We used three inter-related reviews of quantitative and qualitative evidence. Firstly, using pre-existing models and theories, we developed a conceptual framework to inform our understanding of the contexts and mechanisms which influence reminder effectiveness. Secondly, we performed a review following Centre for Reviews and Dissemination guidelines to investigate the effectiveness of different methods of reminding patients to attend health service appointments. Finally, to supplement the effectiveness information, we completed a review informed by realist principles to identify factors likely to influence non-attendance behaviors and the effectiveness of reminders. We found consistent evidence that all types of reminder systems are effective at improving appointment attendance across a range of health care settings and patient populations. Reminder systems may also increase cancellation and rescheduling of unwanted appointments. “Reminder plus”, which provides additional information beyond the reminder function may be more effective than simple reminders (ie, date, time, place) at reducing non-attendance at appointments in particular circumstances. We identified six areas of inefficiency which indicate that reminder systems are being used sub-optimally. Unless otherwise indicated, all patients should receive a reminder to facilitate attendance at their health care appointment. The choice of reminder system should be tailored to the individual service. To optimize appointment and reminder systems, health care services need supportive administrative processes to enhance attendance, cancellation, rescheduling, and re-allocation of appointments to other patients. PMID:27110102

Appointment reminder systems are effective but not optimal: results of a systematic review and evidence synthesis employing realist principles.

PubMed

McLean, Sionnadh Mairi; Booth, Andrew; Gee, Melanie; Salway, Sarah; Cobb, Mark; Bhanbhro, Sadiq; Nancarrow, Susan A

2016-01-01

Missed appointments are an avoidable cost and resource inefficiency which impact upon the health of the patient and treatment outcomes. Health care services are increasingly utilizing reminder systems to manage these negative effects. This study explores the effectiveness of reminder systems for promoting attendance, cancellations, and rescheduling of appointments across all health care settings and for particular patient groups and the contextual factors which indicate that reminders are being employed sub-optimally. We used three inter-related reviews of quantitative and qualitative evidence. Firstly, using pre-existing models and theories, we developed a conceptual framework to inform our understanding of the contexts and mechanisms which influence reminder effectiveness. Secondly, we performed a review following Centre for Reviews and Dissemination guidelines to investigate the effectiveness of different methods of reminding patients to attend health service appointments. Finally, to supplement the effectiveness information, we completed a review informed by realist principles to identify factors likely to influence non-attendance behaviors and the effectiveness of reminders. We found consistent evidence that all types of reminder systems are effective at improving appointment attendance across a range of health care settings and patient populations. Reminder systems may also increase cancellation and rescheduling of unwanted appointments. "Reminder plus", which provides additional information beyond the reminder function may be more effective than simple reminders (ie, date, time, place) at reducing non-attendance at appointments in particular circumstances. We identified six areas of inefficiency which indicate that reminder systems are being used sub-optimally. Unless otherwise indicated, all patients should receive a reminder to facilitate attendance at their health care appointment. The choice of reminder system should be tailored to the individual service. To optimize appointment and reminder systems, health care services need supportive administrative processes to enhance attendance, cancellation, rescheduling, and re-allocation of appointments to other patients.

77 FR 37710 - Notice of Proposed Information Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-22

... to continue the collection of information for two technical training program course effectiveness... approval. This collection is for OSM's Technical Training Program Course Effectiveness Evaluations (1029... collection activity: Title: Technical Training Program Course Effectiveness Evaluation. OMB Control Number...

76 FR 60029 - Notice of Issuance Technical Bulletin 2011-2, Extended Deferral of the Effective Date of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-28

... FEDERAL ACCOUNTING STANDARDS ADVISORY BOARD Notice of Issuance Technical Bulletin 2011-2, Extended Deferral of the Effective Date of Technical Bulletin 2006-1 AGENCY: Federal Accounting Standards Advisory... hereby given that the Federal Accounting Standards Advisory Board (FASAB) has issued Technical Bulletin...

Removing Inefficiencies in the Nation's Job Training Programs. Hearing before the Subcommittee on Higher Education and Workforce Training, Committee on Education and the Workforce, U.S. House of Representatives, One Hundred Twelfth Congress, First Session (May 11, 2011). Serial Number 112-21

ERIC Educational Resources Information Center

US House of Representatives, 2011

2011-01-01

This hearing reviewed ways individuals can make federal job training programs more efficient and effective. Such programs are critical to fostering a competitive workforce and assisting unemployed citizens. However, serious concerns about program fragmentation and potential duplication exist that could result in significant waste. This Committee…

Enabling Energy Efficiency in South Africa's Commercial Buildings

DOE Office of Scientific and Technical Information (OSTI.GOV)

2016-04-01

South Africa is leading a number of efforts to support a thriving economy while also reducing energy use. Increasing energy demand coupled with a highly energy intensive economy and energy inefficient industries provide the backdrop for strong government action underway in South Africa. This brochure details how the Clean Energy Solutions Center supported development of the Regulations on Allowance for the Energy Efficiency Savings legislation designed to provide a framework for effective energy efficiency regulation, incentives and energy reduction targets for South Africa's commercial buildings sector.

Analyzing the Validity of Relationship Banking through Agent-based Modeling

NASA Astrophysics Data System (ADS)

Nishikido, Yukihito; Takahashi, Hiroshi

This article analyzes the validity of relationship banking through agent-based modeling. In the analysis, we especially focus on the relationship between economic conditions and both lenders' and borrowers' behaviors. As a result of intensive experiments, we made the following interesting findings: (1) Relationship banking contributes to reducing bad loan; (2) relationship banking is more effective in enhancing the market growth compared to transaction banking, when borrowers' sales scale is large; (3) keener competition among lenders may bring inefficiency to the market.

Development of a portable teleoperated robot for the manipulation of a backhoe shovel for the restoration of disaster-stricken sites

NASA Astrophysics Data System (ADS)

Tanaka, Toshihiko; Sakai, Yosiharu; Konomi, Yosiyuki; Chayama, Kazuhiro; Minamoto, Masahiko; Matsunaga, Katsuya

1999-11-01

Restoration activities after disasters such as landslides or rock avalanches require rapid action, but in fact, in most cases these activities are very inefficient because of the danger of secondary disasters. A system which can operate reconstruction machinery by remote control was therefore developed, and it was installed on general-purpose construction machines (backhoe shovels). Control performance experiments and field experiments on this developed system were carried out, and its effectiveness was confirmed.

Background field Landau mode operators for the nucleon

NASA Astrophysics Data System (ADS)

Kamleh, Waseem; Bignell, Ryan; Leinweber, Derek B.; Burkardt, Matthias

2018-03-01

The introduction of a uniform background magnetic field breaks threedimensional spatial symmetry for a charged particle and introduces Landau mode effects. Standard quark operators are inefficient at isolating the nucleon correlation function at nontrivial field strengths. We introduce novel quark operators constructed from the twodimensional Laplacian eigenmodes that describe a charged particle on a finite lattice. These eigenmode-projected quark operators provide enhanced precision for calculating nucleon energy shifts in a magnetic field. Preliminary results are obtained for the neutron and proton magnetic polarisabilities using these methods.

Characterization of Rous sarcoma virus polyadenylation site use in vitro

DOE Office of Scientific and Technical Information (OSTI.GOV)

Maciolek, Nicole L.; McNally, Mark T.

2008-05-10

Polyadenylation of Rous sarcoma virus (RSV) RNA is inefficient, as approximately 15% of RSV RNAs represent read-through transcripts that use a downstream cellular polyadenylation site (poly(A) site). Read-through transcription has implications for the virus and the host since it is associated with oncogene capture and tumor induction. To explore the basis of inefficient RSV RNA 3'-end formation, we characterized RSV polyadenylation in vitro using HeLa cell nuclear extracts and HEK293 whole cell extracts. RSV polyadenylation substrates composed of the natural 3' end of viral RNA and various lengths of upstream sequence showed little or no polyadenylation, indicating that the RSVmore » poly(A) site is suboptimal. Efficiently used poly(A) sites often have identifiable upstream and downstream elements (USEs and DSEs) in close proximity to the conserved AAUAAA signal. The sequences upstream and downstream of the RSV poly(A) site deviate from those found in efficiently used poly(A) sites, which may explain inefficient RSV polyadenylation. To assess the quality of the RSV USEs and DSEs, the well-characterized SV40 late USEs and/or DSEs were substituted for the RSV elements and vice versa, which showed that the USEs and DSEs from RSV are suboptimal but functional. CstF interacted poorly with the RSV polyadenylation substrate, and the inactivity of the RSV poly(A) site was at least in part due to poor CstF binding since tethering CstF to the RSV substrate activated polyadenylation. Our data are consistent with poor polyadenylation factor binding sites in both the USE and DSE as the basis for inefficient use of the RSV poly(A) site and point to the importance of additional elements within RSV RNA in promoting 3' end formation.« less

Mechanisms of right ventricular electromechanical dyssynchrony and mechanical inefficiency in children after repair of tetralogy of fallot.

PubMed

Hui, Wei; Slorach, Cameron; Dragulescu, Andreea; Mertens, Luc; Bijnens, Bart; Friedberg, Mark K

2014-07-01

Right bundle branch block and right ventricular (RV) dysfunction are common after tetralogy of Fallot repair (rTOF). We hypothesized that right bundle branch block is associated with specific RV mechanical dyssynchrony and inefficient contraction. We studied rTOF children and age-matched controls. QRS duration and morphology were assessed. RV mechanical dyssynchrony, indicated by early septal activation (right-sided septal flash), RV lateral wall prestretch/late contraction, postsystolic shortening, and intraventricular delay were analyzed using 2-dimensional strain echocardiography. Peak oxygen consumption reflected exercise capacity. Pulmonary regurgitation and RV volumes were assessed by MRI. Forty-six rTOF patients and 46 controls were studied. Ninety-three percent of rTOF patients demonstrated a right-sided septal flash with simultaneous RV basal lateral wall prestretch/late activation. The RV basal segment was the most delayed in onset (115 [0-194] versus 35 [0-96] ms) and termination (462 [369-706] versus 412 [325-529] ms) of longitudinal shortening, with postsystolic shortening. QRS duration correlated with RV basal time to onset and peak shortening (P<0.05). Intra-RV delay was higher in rTOF (P<0.05) in association with RV dilatation (r=0.33; P=0.04). In rTOF, RV mechanics were inefficient, with prestretch and postsystolic shortening comprising 15±11% and 16±9% of total shortening, respectively. A composite parameter of electric and mechanical dyssynchrony correlated with RV end-diastolic volume (r=0.39; P=0.03). Typical electromechanical dyssynchrony associated with mechanical inefficiency, regional dysfunction, and RV dilatation is common in rTOF children, possibly contributing to progressive RV dysfunction. The potential of cardiac resynchronization in appropriate patients requires further study. © 2014 American Heart Association, Inc.

Black holes in short period X-ray binaries and the transition to radiatively inefficient accretion

NASA Astrophysics Data System (ADS)

Knevitt, G.; Wynn, G. A.; Vaughan, S.; Watson, M. G.

2014-02-01

By comparing the orbital period distributions of black hole and neutron star low-mass X-ray binaries (LMXBs) in the Ritter-Kolb catalogue we show that there is statistical evidence for a dearth of black hole systems at short orbital periods (Porb < 4 h). This could either be due to a true divergence in orbital period distributions of these two types of system, or to black hole LMXBs being preferentially hidden from view at short orbital periods. We explore the latter possibility, by investigating whether black hole LMXBs could be concealed by a switch to radiatively inefficient accretion at low luminosities. The peak luminosity and the duration of X-ray binary outbursts are related to the disc radius and, hence, the orbital period. At short periods, where the peak outburst luminosity drops close to the threshold for radiatively inefficient accretion, black hole LMXBs have lower outburst luminosities, shorter outburst durations and lower X-ray duty cycles than comparable neutron star systems. These factors can combine to severely reduce the detection probability of short period black hole LMXBs relative to those containing neutron stars. We estimate the outburst properties and orbital period distribution of black hole LMXBs using two models of the transition to radiatively inefficient accretion: an instantaneous drop in accretion efficiency (η) to zero, at a fraction (f) of the Eddington luminosity (LEdd) and a power-law efficiency decrease, η ∝ dot{M}^n, for L < f LEdd. We show that a population of black hole LMXBs at short orbital periods can only be hidden by a sharp drop in efficiency, either instantaneous or for n ≳ 3. This could be achieved by a genuine drop in luminosity or through abrupt spectral changes that shift the accretion power out of a given X-ray band.

Wind Energy Forecasting: A Collaboration of the National Center for Atmospheric Research (NCAR) and Xcel Energy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Parks, K.; Wan, Y. H.; Wiener, G.

2011-10-01

The focus of this report is the wind forecasting system developed during this contract period with results of performance through the end of 2010. The report is intentionally high-level, with technical details disseminated at various conferences and academic papers. At the end of 2010, Xcel Energy managed the output of 3372 megawatts of installed wind energy. The wind plants span three operating companies1, serving customers in eight states2, and three market structures3. The great majority of the wind energy is contracted through power purchase agreements (PPAs). The remainder is utility owned, Qualifying Facilities (QF), distributed resources (i.e., 'behind the meter'),more » or merchant entities within Xcel Energy's Balancing Authority footprints. Regardless of the contractual or ownership arrangements, the output of the wind energy is balanced by Xcel Energy's generation resources that include fossil, nuclear, and hydro based facilities that are owned or contracted via PPAs. These facilities are committed and dispatched or bid into day-ahead and real-time markets by Xcel Energy's Commercial Operations department. Wind energy complicates the short and long-term planning goals of least-cost, reliable operations. Due to the uncertainty of wind energy production, inherent suboptimal commitment and dispatch associated with imperfect wind forecasts drives up costs. For example, a gas combined cycle unit may be turned on, or committed, in anticipation of low winds. The reality is winds stayed high, forcing this unit and others to run, or be dispatched, to sub-optimal loading positions. In addition, commitment decisions are frequently irreversible due to minimum up and down time constraints. That is, a dispatcher lives with inefficient decisions made in prior periods. In general, uncertainty contributes to conservative operations - committing more units and keeping them on longer than may have been necessary for purposes of maintaining reliability. The downside is costs are higher. In organized electricity markets, units that are committed for reliability reasons are paid their offer price even when prevailing market prices are lower. Often, these uplift charges are allocated to market participants that caused the inefficient dispatch in the first place. Thus, wind energy facilities are burdened with their share of costs proportional to their forecast errors. For Xcel Energy, wind energy uncertainty costs manifest depending on specific market structures. In the Public Service of Colorado (PSCo), inefficient commitment and dispatch caused by wind uncertainty increases fuel costs. Wind resources participating in the Midwest Independent System Operator (MISO) footprint make substantial payments in the real-time markets to true-up their day-ahead positions and are additionally burdened with deviation charges called a Revenue Sufficiency Guarantee (RSG) to cover out of market costs associated with operations. Southwest Public Service (SPS) wind plants cause both commitment inefficiencies and are charged Southwest Power Pool (SPP) imbalance payments due to wind uncertainty and variability. Wind energy forecasting helps mitigate these costs. Wind integration studies for the PSCo and Northern States Power (NSP) operating companies have projected increasing costs as more wind is installed on the system due to forecast error. It follows that reducing forecast error would reduce these costs. This is echoed by large scale studies in neighboring regions and states that have recommended adoption of state-of-the-art wind forecasting tools in day-ahead and real-time planning and operations. Further, Xcel Energy concluded reduction of the normalized mean absolute error by one percent would have reduced costs in 2008 by over $1 million annually in PSCo alone. The value of reducing forecast error prompted Xcel Energy to make substantial investments in wind energy forecasting research and development.« less

Training cognitive flexibility in patients with anorexia nervosa: a pilot randomized controlled trial of cognitive remediation therapy.

PubMed

Brockmeyer, Timo; Ingenerf, Katrin; Walther, Stephan; Wild, Beate; Hartmann, Mechthild; Herzog, Wolfgang; Bents, Hinrich; Friederich, Hans-Christoph

2014-01-01

Inefficient cognitive flexibility is considered a neurocognitive trait marker involved in the development and maintenance of anorexia nervosa (AN). Cognitive Remediation Therapy (CRT) is a specific treatment targeting this cognitive style. The aim of this study was to investigate the feasibility and efficacy (by estimating the effect size) of specifically tailored CRT for AN, compared to non-specific cognitive training. A prospective, randomized controlled, superiority pilot trial was conducted. Forty women with AN receiving treatment as usual (TAU) were randomized to receive either CRT or non-specific neurocognitive therapy (NNT) as an add-on. Both conditions comprised 30 sessions of computer-assisted (21 sessions) and face-to-face (9 sessions) training over a 3-week period. CRT focused specifically on cognitive flexibility. NNT was comprised of tasks designed to improve attention and memory. The primary outcome was performance on a neuropsychological post-treatment assessment of cognitive set-shifting. Data available from 25 treatment completers were analyzed. Participants in the CRT condition outperformed participants in the NNT condition in cognitive set-shifting at the end of the treatment (p = 0.027; between-groups effect size d = 0.62). Participants in both conditions showed high treatment acceptance. This study confirms the feasibility of CRT for AN, and provides a first estimate of the effect size that can be achieved using CRT for AN. Furthermore, the present findings corroborate that neurocognitive training for AN should be tailored to the specific cognitive inefficiencies of this patient group. Copyright © 2013 Wiley Periodicals, Inc.

Subglacial Hydrology Model Intercomparison Project (SHMIP)

NASA Astrophysics Data System (ADS)

Werder, Mauro A.; de Fleurian, Basile; Creyts, Timothy T.; Damsgaard, Anders; Delaney, Ian; Dow, Christine F.; Gagliardini, Olivier; Hoffman, Matthew J.; Seguinot, Julien; Sommers, Aleah; Irarrazaval Bustos, Inigo; Downs, Jakob

2017-04-01

The SHMIP project is the first intercomparison project of subglacial drainage models (http://shmip.bitbucket.org). Its synthetic test suites and evaluation were designed such that any subglacial hydrology model producing effective pressure can participate. In contrast to ice deformation, the physical processes of subglacial hydrology (which in turn impacts basal sliding of glaciers) are poorly known. A further complication is that different glacial and geological settings can lead to different drainage physics. The aim of the project is therefore to qualitatively compare the outputs of the participating models for a wide range of water forcings and glacier geometries. This will allow to put existing studies, which use different drainage models, into context and will allow new studies to select the most suitable model for the problem at hand. We present the results from the just completed intercomparison exercise. Twelve models participated: eight 2D and four 1D models; nine include both an efficient and inefficient system, the other three one of the systems; all but two models use R-channels as efficient system, and/or a linked-cavity like inefficient system, one exception uses porous layers with different characteristic for each of the systems, the other exception is based on canals. The main variable used for the comparison is effective pressure, as that is a direct proxy for basal sliding of glaciers. The models produce large differences in the effective pressure fields, in particular for higher water input scenarios. This shows that the selection of a subglacial drainage model will likely impact the conclusions of a study significantly.

Roguing with replacement in perennial crops: conditions for successful disease management.

PubMed

Sisterson, Mark S; Stenger, Drake C

2013-02-01

Replacement of diseased plants with healthy plants is commonly used to manage spread of plant pathogens in perennial cropping systems. This strategy has two potential benefits. First, removing infected plants may slow pathogen spread by eliminating inoculum sources. Second, replacing infected plants with uninfected plants may offset yield losses due to disease. The extent to which these benefits are realized depends on multiple factors. In this study, sensitivity analyses of two spatially explicit simulation models were used to evaluate how assumptions concerning implementation of a plant replacement program and pathogen spread interact to affect disease suppression. In conjunction, effects of assumptions concerning yield loss associated with disease and rates of plant maturity on yields were simultaneously evaluated. The first model was used to evaluate effects of plant replacement on pathogen spread and yield on a single farm, consisting of a perennial crop monoculture. The second model evaluated effects of plant replacement on pathogen spread and yield in a 100 farm crop growing region, with all farms maintaining a monoculture of the same perennial crop. Results indicated that efficient replacement of infected plants combined with a high degree of compliance among farms effectively slowed pathogen spread, resulting in replacement of few plants and high yields. In contrast, inefficient replacement of infected plants or limited compliance among farms failed to slow pathogen spread, resulting in replacement of large numbers of plants (on farms practicing replacement) with little yield benefit. Replacement of infected plants always increased yields relative to simulations without plant replacement provided that infected plants produced no useable yield. However, if infected plants produced useable yields, inefficient removal of infected plants resulted in lower yields relative to simulations without plant replacement for perennial crops with long maturation periods in some cases.

Chapter 11. Fuel Economy: The Case for Market Failure

DOE Office of Scientific and Technical Information (OSTI.GOV)

Greene, David L; German, John; Delucchi, Mark A

2009-01-01

The efficiency of energy using durable goods, from automobiles to home air conditioners, is not only a key determinant of economy-wide energy use but also of greenhouse gas (GHG) emissions, climate change and energy insecurity. Energy analysts have long noted that consumers appear to have high implicit discount rates for future fuel savings when choosing among energy using durable goods (Howarth and Sanstad, 1995). In modeling consumers choices of appliances, the Energy Information Administration (EIA) has used discount rates of 30 percent for heating systems, 69 percent for choice of refrigerator and up to 111 percent for choice of watermore » heater (U.S. DOE/EIA, 1996). Several explanations have been offered for this widespread phenomenon, including asymmetric information, bounded rationality and transaction costs. This chapter argues that uncertainty combined with loss aversion by consumers is sufficient to explain the failure to adopt cost effective energy efficiency improvements in the market for automotive fuel economy, although other market failures appear to be present as well. Understanding how markets for energy efficiency function is crucial to formulating effective energy policies (see Pizer, 2006). Fischer et al., (2004), for example, demonstrated that if consumers fully value the discounted present value of future fuel savings, fuel economy standards are largely redundant and produce small welfare losses. However, if consumers value only the first three years of fuel savings, then fuel economy standards can significantly increase consumer welfare. The nature of any market failure that might be present in the market for energy efficiency would also affect the relative efficacy of energy taxes versus regulatory standards (CBO, 2003). If markets function efficiently, energy taxes would generally be more efficient than regulatory standards in increasing energy efficiency and reducing energy use. If markets are decidedly inefficient, standards would likely be more effective. The chapter explores the roles of uncertainty and loss-aversion in the market for automotive fuel economy. The focus is on the determination of the technical efficiency of the vehicle rather than consumers choices among vehicles. Over the past three decades, changes in the mix of vehicles sold has played little if any role in raising the average fuel economy of new light-duty vehicles from 13 miles per gallon (mpg) in 1975 to 21 mpg today (Heavenrich, 2006). Over that same time period, average vehicle weight is up 2 percent, horsepower is up 60 percent, passenger car interior volume increased by 2 percent and the market share of light trucks grew by 31 percentage points. Historically, at least, increasing light-duty vehicle fuel economy in the United States has been a matter of manufacturers decisions to apply technology to increase the technical efficiency of cars and light trucks. Understanding how efficiently the market determines the technical fuel economy of new vehicles would seem to be critical to formulating effective policies to encourage future fuel economy improvement. The central issue is whether or not the market for fuel economy is economically efficient. Rubenstein (1998) lists the key assumptions of the rational economic decision model. The decision maker must have a clear picture of the choice problem he or she faces. He should be fully aware of the set of alternatives from which to choose and have the skill necessary to make complicated calculations needed to discover the optimal course of action. Finally, the decision maker should have the unlimited ability to calculate and be indifferent to alternatives and choice sets.« less

Virtuous and vicious virtual water trade with application to Italy.

PubMed

Winter, Julia Anna; Allamano, Paola; Claps, Pierluigi

2014-01-01

The current trade of agricultural goods, with connections involving all continents, entails for global exchanges of "virtual" water, i.e. water used in the production process of alimentary products, but not contained within. Each trade link translates into a corresponding virtual water trade, allowing quantification of import and export fluxes of virtual water. The assessment of the virtual water import for a given nation, compared to the national consumption, could give an approximate idea of the country's reliance on external resources from the food and the water resources point of view. A descriptive approach to the understanding of a nation's degree of dependency from overseas food and water resources is first proposed, and indices of water trade virtuosity, as opposed to inefficiency, are devised. Such indices are based on the concepts of self-sufficiency and relative export, computed systematically on all products from the FAOSTAT database, taking Italy as the first case study. Analysis of time series of the self-sufficiency and relative export can demonstrate effects of market tendencies and influence water-related policies at the international level. The goal of this approach is highlighting incongruent terms in the virtual water balances by the viewpoint of single products. Specific products, which are here referred to as "swap products", are in fact identified as those that lead to inefficiencies in the virtual water balance due to their contemporaneously high import and export. The inefficiencies due to the exchanges of the same products between two nations are calculated in terms of virtual water volumes. Furthermore, the cases of swap products are investigated by computing two further indexes denoting the ratio of virtual water exchanged in the swap and the ratio of the economic values of the swapped products. The analysis of these figures can help examine the reasons behind the swap phenomenon in trade.

Global Survey of the Concepts and Understanding of the Interfaces Between Nuclear Safety, Security, and Safeguards

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kovacic, Don N.; Stewart, Scott; Erickson, Alexa R.

There is increasing global discourse on how the elements of nuclear safety, security, and safeguards can be most effectively implemented in nuclear power programs. While each element is separate and unique, they must nevertheless all be addressed in a country’s laws and implemented via regulations and in facility operations. This topic is of particular interest to countries that are currently developing the infrastructure to support nuclear power programs. These countries want to better understand what is required by these elements and how they can manage the interfaces between them and take advantages of any synergies that may exist. They needmore » practical examples and guidance in this area in order to develop better organizational strategies and technical capacities. This could simplify their legal, regulatory, and management structures and avoid inefficient approaches and costly mistakes that may not be apparent to them at this early stage of development. From the perspective of IAEA International Safeguards, supporting Member States in exploring such interfaces and synergies provides a benefit to them because it acknowledges that domestic safeguards in a country do not exist in a vacuum. Instead, it relies on a strong State System of Accounting and Control that is in turn dependent on a capable and independent regulatory body as well as a competent operator and technical staff. These organizations must account for and control nuclear material, communicate effectively, and manage and transmit complete and correct information to the IAEA in a timely manner. This, while in most cases also being responsible for the safety and security of their facilities. Seeking efficiencies in this process benefits international safeguards and nonproliferation. This paper will present the results of a global survey of current and anticipated approaches and practices by countries and organizations with current or future nuclear power programs on how they are implementing, or planning to implement, safety, security, and safeguards in their programs. The idea is to capture current knowledge and thinking on this topic and to identify common themes in organizations and management. It will also document the most commonly held ideas and perception (and misperceptions) of what it means to manage interfaces and take advantage of synergies for operating nuclear facilities and those that are building their infrastructures. It is desired that the results of this paper will inform the current discourse on this topic with some quantitative data and identify any general trends in understanding.« less

Information vs advertising in the market for hospital care.

PubMed

Montefiori, Marcello

2008-09-01

Recent health care reforms have introduced prospective payments and have allowed patients to choose their preferred providers. The expected outcome is efficiency in production and an increase in the quality level. The former objective should be obtained by the prospective payment scheme; the latter by the demand mechanism, through the competition between providers. Unfortunately, because of asymmetry of information, patients are unable to observe the true quality and the demand for health care services depends on a perceived quality as influenced by the hospital advertising. Inefficiency in the resource allocation and social welfare loss are the two likely effects. In this paper we show how the purchaser can implement effective policies to overcome these undesired effects.

Impact of Installation Faults on Heat Pump Performance

DOE PAGES

Hourahan, Glenn; Baxter, Van D.

2015-01-01

Numerous studies and surveys indicate that typically-installed HVAC equipment operate inefficiently and waste considerable energy due to varied installation errors (faults) such as improper refrigerant charge, incorrect airflow, oversized equipment, and leaky ducts. This article summarizes the results of a large United States (U.S.) experimental/analytical study (U.S. contribution to IEA HPP Annex 36) of the impact that different faults have on the performance of an air-source heat pump (ASHP) in a typical U.S. single-family house. It combines building effects, equipment effects, and climate effects in an evaluation of the faults impact on seasonal energy consumption through simulations of the house/ASHPmore » pump system.« less

Payment policy and inefficient benefits in the Medicare+Choice program.

PubMed

Pizer, Steven D; Frakt, Austin B; Feldman, Roger

2003-06-01

We investigated whether constraints on premium rebates by health plans in the Medicare+Choice program result in inefficient benefits. Since relationships between revenue and benefits could be confounded by unobserved variation in the cost of coverage, we took advantage of natural experiment that occurred following passage of the Benefits Improvement and Protection Act of 2000. Our findings indicate that benefits in zero premium plans were more sensitive to changes in payment rates than were benefits in plans that charged nonzero premiums. These results strongly suggest that current Medicare policy induces plans to offer benefits that are not valued by enrollees at or above their cost.

Pricing and Welfare in Health Plan Choice.

PubMed

Bundorf, M Kate; Levin, Jonathan; Mahoney, Neale

2012-12-01

Premiums in health insurance markets frequently do not reflect individual differences in costs, either because consumers have private information or because prices are not risk rated. This creates inefficiencies when consumers self-select into plans. We develop a simple econometric model to study this problem and estimate it using data on small employers. We find a welfare loss of 2-11 percent of coverage costs compared to what is feasible with risk rating. Only about one-quarter of this is due to inefficiently chosen uniform contribution levels. We also investigate the reclassification risk created by risk rating individual incremental premiums, finding only a modest welfare cost.

How to design a targeted agricultural subsidy system: efficiency or equity?

PubMed

Cong, Rong-Gang; Brady, Mark

2012-01-01

In this paper we appraise current agricultural subsidy policy in the EU. Several sources of its inefficiency are identified: it is inefficient for supporting farmers' incomes or guaranteeing food security, and irrational transfer payments decoupled from actual performance that may be negative for environmental protection, social cohesion, etc. Based on a simplified economic model, we prove that there is "reverse redistribution" in the current tax-subsidy system, which cannot be avoided. To find a possible way to distribute subsidies more efficiently and equitably, several alternative subsidy systems (the pure loan, the harvest tax and the income contingent loan) are presented and examined.

Fractal stock markets: International evidence of dynamical (in)efficiency.

PubMed

Bianchi, Sergio; Frezza, Massimiliano

2017-07-01

The last systemic financial crisis has reawakened the debate on the efficient nature of financial markets, traditionally described as semimartingales. The standard approaches to endow the general notion of efficiency of an empirical content turned out to be somewhat inconclusive and misleading. We propose a topological-based approach to quantify the informational efficiency of a financial time series. The idea is to measure the efficiency by means of the pointwise regularity of a (stochastic) function, given that the signature of a martingale is that its pointwise regularity equals 12. We provide estimates for real financial time series and investigate their (in)efficient behavior by comparing three main stock indexes.

The turbulent formation of stars

NASA Astrophysics Data System (ADS)

Federrath, Christoph

2018-06-01

How stars are born from clouds of gas is a rich physics problem whose solution will inform our understanding of not just stars but also planets, galaxies, and the universe itself. Star formation is stupendously inefficient. Take the Milky Way. Our galaxy contains about a billion solar masses of fresh gas available to form stars-and yet it produces only one solar mass of new stars a year. Accounting for that inefficiency is one of the biggest challenges of modern astrophysics. Why should we care about star formation? Because the process powers the evolution of galaxies and sets the initial conditions for planet formation and thus, ultimately, for life.

Functional programming interpreter. M. S. thesis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Robison, A.D.

1987-03-01

Functional Programming (FP) sup BAC87 is an alternative to conventional imperative programming languages. This thesis describes an FP interpreter implementation. Superficially, FP appears to be a simple, but very inefficient language. Its simplicity, however, allows it to be interpreted quickly. Much of the inefficiency can be removed by simple interpreter techniques. This thesis describes the Illinois Functional Programming (IFP) interpreter, an interactive functional programming implementation which runs under both MS-DOS and UNIX. The IFP interpreter allows functions to be created, executed, and debugged in an environment very similar to UNIX. IFP's speed is competitive with other interpreted languages such asmore » BASIC.« less

How to Design a Targeted Agricultural Subsidy System: Efficiency or Equity?

PubMed Central

Cong, Rong-Gang; Brady, Mark

2012-01-01

In this paper we appraise current agricultural subsidy policy in the EU. Several sources of its inefficiency are identified: it is inefficient for supporting farmers’ incomes or guaranteeing food security, and irrational transfer payments decoupled from actual performance that may be negative for environmental protection, social cohesion, etc. Based on a simplified economic model, we prove that there is “reverse redistribution” in the current tax-subsidy system, which cannot be avoided. To find a possible way to distribute subsidies more efficiently and equitably, several alternative subsidy systems (the pure loan, the harvest tax and the income contingent loan) are presented and examined. PMID:22876283

Fractal stock markets: International evidence of dynamical (in)efficiency

NASA Astrophysics Data System (ADS)

Bianchi, Sergio; Frezza, Massimiliano

2017-07-01

The last systemic financial crisis has reawakened the debate on the efficient nature of financial markets, traditionally described as semimartingales. The standard approaches to endow the general notion of efficiency of an empirical content turned out to be somewhat inconclusive and misleading. We propose a topological-based approach to quantify the informational efficiency of a financial time series. The idea is to measure the efficiency by means of the pointwise regularity of a (stochastic) function, given that the signature of a martingale is that its pointwise regularity equals 1/2 . We provide estimates for real financial time series and investigate their (in)efficient behavior by comparing three main stock indexes.

Optimal powering schemes for legged robotics

NASA Astrophysics Data System (ADS)

Muench, Paul; Bednarz, David; Czerniak, Gregory P.; Cheok, Ka C.

2010-04-01

Legged Robots have tremendous mobility, but they can also be very inefficient. These inefficiencies can be due to suboptimal control schemes, among other things. If your goal is to get from point A to point B in the least amount of time, your control scheme will be different from if your goal is to get there using the least amount of energy. In this paper, we seek a balance between these extremes by looking at both efficiency and speed. We model a walking robot as a rimless wheel, and, using Pontryagin's Maximum Principle (PMP), we find an "on-off" control for the model, and describe the switching curve between these control extremes.

Collaborative learning in networks.

PubMed

Mason, Winter; Watts, Duncan J

2012-01-17

Complex problems in science, business, and engineering typically require some tradeoff between exploitation of known solutions and exploration for novel ones, where, in many cases, information about known solutions can also disseminate among individual problem solvers through formal or informal networks. Prior research on complex problem solving by collectives has found the counterintuitive result that inefficient networks, meaning networks that disseminate information relatively slowly, can perform better than efficient networks for problems that require extended exploration. In this paper, we report on a series of 256 Web-based experiments in which groups of 16 individuals collectively solved a complex problem and shared information through different communication networks. As expected, we found that collective exploration improved average success over independent exploration because good solutions could diffuse through the network. In contrast to prior work, however, we found that efficient networks outperformed inefficient networks, even in a problem space with qualitative properties thought to favor inefficient networks. We explain this result in terms of individual-level explore-exploit decisions, which we find were influenced by the network structure as well as by strategic considerations and the relative payoff between maxima. We conclude by discussing implications for real-world problem solving and possible extensions.

Collaborative learning in networks

PubMed Central

Mason, Winter; Watts, Duncan J.

2012-01-01

Complex problems in science, business, and engineering typically require some tradeoff between exploitation of known solutions and exploration for novel ones, where, in many cases, information about known solutions can also disseminate among individual problem solvers through formal or informal networks. Prior research on complex problem solving by collectives has found the counterintuitive result that inefficient networks, meaning networks that disseminate information relatively slowly, can perform better than efficient networks for problems that require extended exploration. In this paper, we report on a series of 256 Web-based experiments in which groups of 16 individuals collectively solved a complex problem and shared information through different communication networks. As expected, we found that collective exploration improved average success over independent exploration because good solutions could diffuse through the network. In contrast to prior work, however, we found that efficient networks outperformed inefficient networks, even in a problem space with qualitative properties thought to favor inefficient networks. We explain this result in terms of individual-level explore-exploit decisions, which we find were influenced by the network structure as well as by strategic considerations and the relative payoff between maxima. We conclude by discussing implications for real-world problem solving and possible extensions. PMID:22184216

Inter-Regional Performance of the Public Health System in a High-Inequality Country

PubMed Central

Gramani, Maria Cristina

2014-01-01

Previous cross-country studies have revealed a relationship between health and socio-economic factors. However, multinational studies that use aggregate figures could obfuscate the actual situation in each individual region, or even in each individual federal unit, mainly in a developing country that spans a continent and has large socioeconomic inequalities. We conducted a within-country study, in Brazil, of health system performance that examined data in the four perspectives that most strongly affect the performance of public health systems: financial, customer, internal processes and learning&growth. After estimating the interregional health system performance from each perspective, we identified the determinants of inefficiency (i.e., the factors that have the greatest potential for improvement in each region). The results showed that the major determinants of inefficiency in the less efficient regions (N and NE) are concentrated in the perspective of learning&growth (the number of health professionals and the number of graduates with a health-related undergraduate degree) and, in the regions with the best performance (S and SE) the major determinants of inefficiency are concentrated in the financial perspective (spending on health care and the amount paid for hospitalization). PMID:24466201

Strategies for the quality assessment of the health care service providers in the treatment of Gastric Cancer in Colombia.

PubMed

Villamil, María Del Pilar; Barrera, David; Velasco, Nubia; Bernal, Oscar; Fajardo, Esteban; Urango, Carlos; Buitrago, Sebastian

2017-09-15

While, at its inception in 1993, the health care system in Colombia was publicized as a paradigm to be copied across the developing world, numerous problems in its implementation have led to, what is now, an inefficient and crisis-ridden health system. Furthermore, as a result of inappropriate tools to measure the quality of the health service providers, several corruption scandals have arisen in the country. This study attempts to tackle this situation by proposing a strategy for the quality assessment of the health service providers (Entidades Promotoras de Salud, EPS) in the Colombian health system. In particular, as a case study, the quality of the treatment of stomach cancer is analyzed. The study uses two complementary techniques to address the problem. These techniques are applied based on data of the treatment of gastric cancer collected on a nation-wide scale by the Colombian Ministry of Health and Welfare. First, Data Envelopment Analysis (DEA) and the Malmquist Index (MI) are used to establish the most efficient EPS's within the system, according to indicators such as opportunity indicators. Second, sequential clustering algorithm, related to process mining a field of data mining, is used to determine the medical history of all patients and to construct typical care pathways of the patients belonging to efficient and inefficient EPS's. Lastly, efforts are made to identify traits and differences between efficient and inefficient EPS's. Efficient and inefficient EPS were identified for the years 2010 and 2011. Additionally, a Malmquist Index was used to calculate the relative changes in the efficiency of the health providers. Using these efficiency rates, the typical treatment path of patients with gastric cancer was found for two EPSs: one efficient and another inefficient. Finally, the typical traits of the care pathways were established. Combining DEA and process mining proved to be a powerful approach understanding the problem and gaining valuable insight into the inner workings of the Colombian Health System, especially in terms of the treatment process performed by health care providers in critical illnesses such as cancer. However, no sufficiently compelling results were found to establish the contribution of such a combination to evaluate the quality in the delivery of health services.

The omega-3 fatty acid nutritional landscape: health benefits and sources.

PubMed

Deckelbaum, Richard J; Torrejon, Claudia

2012-03-01

Dietary fatty acids (FA) are increasingly recognized as major biologic regulators and have properties that relate to health outcomes and disease. The longer chain, more bioactive (n-6) (or omega-6) FA and (n-3) (or omega-3) FA share similar elongation and desaturation enzymes in their conversion from the essential (n-6) FA, linoleic acid, and (n-3) FA, α-linolenic acid (ALA). Conversion from these essential FA is very inefficient. However, now for the (n-3) FA series, soy oil can be enriched with (n-3) stearidonic acid (SDA) to allow for much more efficient conversion to longer chain EPA. EPA and the longer chain DHA possess distinct physical and biological properties that generally impart properties to cells and tissue, which underlie their ability to promote health and prevent disease. Although active in a number of areas of human biology, mechanisms of action of EPA and DHA are perhaps best defined in cardiovascular disease. There is concern that to reach the intake recommendations of EPA and DHA, their supply from cold water fish will be insufficient. Gaps in understanding mechanisms of action of (n-3) FA in a number of health and disease areas as well as optimal sources and intake levels for each need to be defined by further research. Because of the inefficient conversion of ALA, the appearance of SDA in enriched soy oil offers a biologically effective and cost effective approach to providing a sustainable plant source for (n-3) FA in the future.

Information-Pooling Bias in Collaborative Security Incident Correlation Analysis.

PubMed

Rajivan, Prashanth; Cooke, Nancy J

2018-03-01

Incident correlation is a vital step in the cybersecurity threat detection process. This article presents research on the effect of group-level information-pooling bias on collaborative incident correlation analysis in a synthetic task environment. Past research has shown that uneven information distribution biases people to share information that is known to most team members and prevents them from sharing any unique information available with them. The effect of such biases on security team collaborations are largely unknown. Thirty 3-person teams performed two threat detection missions involving information sharing and correlating security incidents. Incidents were predistributed to each person in the team based on the hidden profile paradigm. Participant teams, randomly assigned to three experimental groups, used different collaboration aids during Mission 2. Communication analysis revealed that participant teams were 3 times more likely to discuss security incidents commonly known to the majority. Unaided team collaboration was inefficient in finding associations between security incidents uniquely available to each member of the team. Visualizations that augment perceptual processing and recognition memory were found to mitigate the bias. The data suggest that (a) security analyst teams, when conducting collaborative correlation analysis, could be inefficient in pooling unique information from their peers; (b) employing off-the-shelf collaboration tools in cybersecurity defense environments is inadequate; and (c) collaborative security visualization tools developed considering the human cognitive limitations of security analysts is necessary. Potential applications of this research include development of team training procedures and collaboration tool development for security analysts.

Associations of rumen parameters with feed efficiency and sampling routine in beef cattle.

PubMed

Lam, S; Munro, J C; Zhou, M; Guan, L L; Schenkel, F S; Steele, M A; Miller, S P; Montanholi, Y R

2018-07-01

Characterizing ruminal parameters in the context of sampling routine and feed efficiency is fundamental to understand the efficiency of feed utilization in the bovine. Therefore, we evaluated microbial and volatile fatty acid (VFA) profiles, rumen papillae epithelial and stratum corneum thickness and rumen pH (RpH) and temperature (RT) in feedlot cattle. In all, 48 cattle (32 steers plus 16 bulls), fed a high moisture corn and haylage-based ration, underwent a productive performance test to determine residual feed intake (RFI) using feed intake, growth, BW and composition traits. Rumen fluid was collected, then RpH and RT logger were inserted 5.5±1 days before slaughter. At slaughter, the logger was recovered and rumen fluid and rumen tissue were sampled. The relative daily time spent in specific RpH and RT ranges were determined. Polynomial regression analysis was used to characterize RpH and RT circadian patterns. Animals were divided into efficient and inefficient groups based on RFI to compare productive performance and ruminal parameters. Efficient animals consumed 1.8 kg/day less dry matter than inefficient cattle (P⩽0.05) while achieving the same productive performance (P⩾0.10). Ruminal bacteria population was higher (P⩽0.05) (7.6×1011 v. 4.3×1011 copy number of 16S rRNA gene/ml rumen fluid) and methanogen population was lower (P⩽0.05) (2.3×109 v. 4.9×109 copy number of 16S rRNA gene/ml rumen fluid) in efficient compared with inefficient cattle at slaughter with no differences (P⩾0.10) between samples collected on-farm. No differences (P⩾0.10) in rumen fluid VFA were also observed between feed efficiency groups either on-farm or at slaughter. However, increased (P⩽0.05) acetate, and decreased (P⩽0.05) propionate, butyrate, valerate and caproate concentrations were observed at slaughter compared with on-farm. Efficient had increased (P⩽0.05) rumen epithelium thickness (136 v. 126 µm) compared with inefficient cattle. Efficient animals also spent 318% and 93.2% more time (P⩽0.05) in acidotic (4.14% v. 1.30%) (pH⩽5.6) and optimal (5.6

Isolated Liquid Droplet Combustion: Inhibition and Extinction Studies

NASA Technical Reports Server (NTRS)

Dryer, F. L.; Kroenlein, K. G.; Kazakov, A.; Williams, F. A.; Nayagam, V.

2004-01-01

Introduction of fire suppressants to the ambient environment surrounding a heterogeneous diffusion flame may be an inefficient technique for fire safety in systems without buoyant flows. Carbon dioxide substitution for nitrogen diluent leads to significant modifications of the sphero-symmetric burning behavior of isolated n-heptane droplets, partly through increased heat capacity within the gaseous diffusion flame, but mostly because of modifications in spectral radiative coupling in the gas phase. Effects of longer time scale phenomena such as sooting and slow gas-phase/droplet convection remain to be determined. Similar methodologies can be applied to evaluate the effects and efficacy of chemical inhibitors in the liquid and gas phases.

Photometric detection of high proper motions in dense stellar fields using difference image analysis

NASA Astrophysics Data System (ADS)

Eyer, L.; Woźniak, P. R.

2001-10-01

The difference image analysis (DIA) of the images obtained by the Optical Gravitational Lensing Experiment (OGLE-II) revealed a peculiar artefact in the sample of stars proposed as variable by Woźniak in one of the Galactic bulge fields: the occurrence of pairs of candidate variables showing anti-correlated light curves monotonic over a period of 3yr. This effect can be understood, quantified and related to the stellar proper motions. DIA photometry supplemented with a simple model offers an effective and easy way to detect high proper motion stars in very dense stellar fields, where conventional astrometric searches are extremely inefficient.

Magnetic Microspheres for Therapeutical Applications

NASA Technical Reports Server (NTRS)

Mazuruk, K.; Ramachandran, N.; Curreri, Peter A. (Technical Monitor)

2002-01-01

Hyperthermia is a well known cancer therapy and consists of heating a tumor region to the elevated temperatures in the range of 40-45 C for an extended period of time (2-8 hours). This leads to thermal inactivation of cell regulatory and growth processes with resulting widespread necrosis, carbonization and coagulation. Moreover, heat boosts the tumor response to other treatments such as radiation, chemotherapy or immunotherapy. Of particular importance is careful control of generated heat in the treated region and keeping it localized. Higher heating, to about 56 C can lead to tissue thermo-ablation. With accurate temperature control, hyperthermia has the advantage of having minimal side effects. Several heating techniques are utilized for this purpose, such as whole body hyperthermia, radio-frequency (RF) hyperthermia, ultrasound technique, inductive microwave antenna hyperthermia, inductive needles (thermoseeds), and magnetic fluid hyperthermia (MFH).MFH offers many advantages as targeting capability by applying magnets. However, this technology still suffers significant inefficiencies due to lack of thermal control. This paper will provide a review of the topic and outline the ongoing work in this area. The main emphasis is in devising ways to overcome the technical difficulty in hyperthermia therapy of achieving a uniform therapeutic temperature over the required region of the body and holding it steady. The basic obstacle of the present heating methods are non-uniform thermal properties of the tissue. Our approach is to develop a novel class of magnetic fluids which have inherent thermoregulating properties. We have identified a few magnetic alloys which can serve as a suitable nano-particle material. The objective is to synthesize, characterize and evaluate the efficacy of TRMF for hyperthermia therapy.

Cleaner production: Minimizing hazardous waste in Indonesia

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bratasida, D.L.

In the second long-term development plan, industry plays a significant role in economic growth. In Indonesia, industries grow very fast; such fast growth can adversely effect the environment. Exploitation of assets can mean depletion of natural resources and energy, which, if incorrectly managed, can endanger human life and the environment. The inefficient use of natural resources will accelerate their exhaustion and generate pollution, resulting in environmental damage and threats to economic development and human well being. In recent years, changes in the approach used to control pollution have been necessary because of the increasing seriousness of the problems. Initial environmentalmore » management strategies were based on a carrying capacity approach; the natural assimilative capacity accommodated the pollution load that was applied. The environmental management strategies adopted later included technologies applied to the end of the discharge point (so-called {open_quotes}end-of-pipe{close_quotes} treatments). Until now, environmental management strategies focused on end-of-pipe approaches that control pollutants after they are generated. These approaches concentrate on waste treatment and disposal to control pollution and environmental degradation. However, as industry develops, waste volumes continue to increase, thereby creating further environmental problems. In addition, the wastes produced tend to have more complex characteristics and are potentially more difficult to treat for a reasonable cost. There are often technical and financial obstacles to regulatory compliance if waste treatment is relied on as the only means of achieving environmental objectives. Consequently, the reactive end-of-pipe treatment approach has been changed to a proactive cleaner production approach. This approach is based on the concept of sustainable development and is designed to prevent pollution as well as to protect natural resources and the quality of the environment.« less

An "Inefficient Fin" Non-Dimensional Parameter to Measure Gas Temperatures Efficiently

NASA Technical Reports Server (NTRS)

Lemieux, Patrick; Murray, William; Cooke, Terry; Gerhardt, James

2012-01-01

A gas containment vessel that is not in thermal equilibrium with the bulk gas can affect its temperature measurement. The physical nature of many gas dynamics experiments often makes the accurate measurement of temperature a challenge. The environment itself typically requires that the thermocouple be sheathed, both to protect the wires and hot junction of the instrument from their environment, and to provide a smooth, rigid surface for pressure sealing of the enclosure. However, that enclosure may also be much colder than the gas to be sensed, or vice-versa. Either way, the effect of such gradients is to potentially skew the temperature measurements themselves, since heat may then be conducted by the instrument. Thermocouple designers traditionally address this problem by insulating the sheath from the thermocouple leads and hot junction as much as possible. The thermocouple leads are typically packed in a ceramic powder inside the sheath, protecting them somewhat from temperature gradients along the sheath, but there is no effective mechanism to shield the sheath from the enclosure body itself. Standard practice dictates that thermocouples be used in installations that do not present large thermal gradients along the probe. If this conduction dominates heat transfer near the tip of the probe, then temperature measurements may be expected to be skewed. While the same problem may be experienced in the measurement of temperature at various points within a solid in a gradient, it tends to be aggravated in the measurements of gas temperature, since heat transfer dependent on convection is often less efficient than conduction along the thermocouple. The proposed solution is an inefficient fin thermocouple probe. Conventional wisdom suggests that in many experiments where gas flows through an enclosure (e.g., flow in pipe, manifold, nozzle, etc.), the thermocouple be introduced flush to the surface, so as not to interfere with the flow. In practice, however, many such experiments take place where the flow is already turbulent, so that a protruding thermocouple probe has a negligible effect on the flow characteristics. The key question then becomes just how far into the flow should a thermocouple protrude in order to properly sense the gas temperature at that point. Modeling the thermocouple as an "inefficient fin" directly addresses this question. The appropriate assumptions in this case are: one-dimensional conduction along the fin; steady-state, constant, and homogeneous thermal conductivity; negligible radiation; and a uniform, constant heat transfer coefficient over the probe surface. It is noted that the nature of the ceramic-filled probe makes the key assumption of homogeneous thermal conductivity that much more conservative.

Protocol and practice in the adaptive management of waterfowl harvests

USGS Publications Warehouse

Johnson, F.; Williams, K.

1999-01-01

Waterfowl harvest management in North America, for all its success, historically has had several shortcomings, including a lack of well-defined objectives, a failure to account for uncertain management outcomes, and inefficient use of harvest regulations to understand the effects of management. To address these and other concerns, the U.S. Fish and Wildlife Service began implementation of adaptive harvest management in 1995. Harvest policies are now developed using a Markov decision process in which there is an explicit accounting for uncontrolled environmental variation, partial controllability of harvest, and structural uncertainty in waterfowl population dynamics. Current policies are passively adaptive, in the sense that any reduction in structural uncertainty is an unplanned by-product of the regulatory process. A generalization of the Markov decision process permits the calculation of optimal actively adaptive policies, but it is not yet clear how state-specific harvest actions differ between passive and active approaches. The Markov decision process also provides managers the ability to explore optimal levels of aggregation or "management scale" for regulating harvests in a system that exhibits high temporal, spatial, and organizational variability. Progress in institutionalizing adaptive harvest management has been remarkable, but some managers still perceive the process as a panacea, while failing to appreciate the challenges presented by this more explicit and methodical approach to harvest regulation. Technical hurdles include the need to develop better linkages between population processes and the dynamics of landscapes, and to model the dynamics of structural uncertainty in a more comprehensive fashion. From an institutional perspective, agreement on how to value and allocate harvests continues to be elusive, and there is some evidence that waterfowl managers have overestimated the importance of achievement-oriented factors in setting hunting regulations. Indeed, it is these unresolved value judgements, and the lack of an effective structure for organizing debate, that present the greatest threat to adaptive harvest management as a viable means for coping with management uncertainty. Copyright ?? 1999 by The Resilience Alliance.

Effects of Leadership Styles in Technical and Vocational Students, UTHM

ERIC Educational Resources Information Center

Razak, Nur Afifah Binti Abdul; Hamidon, Nur Izeanty Binti

2015-01-01

Effective leadership helps our nation through times become a developed country. This study was undertaken to investigate the effects of leadership style among students in Technical and Vocational at University Tun Hussein Onn Malaysia. Descriptive study carried out to evaluate student leadership. The study sample consisted of 319 Technical and…

Cost analysis in the toxicology laboratory.

PubMed

Travers, E M

1990-09-01

The process of determining laboratory sectional and departmental costs and test costs for instrument-generated and manually generated reportable results for toxicology laboratories has been outlined in this article. It is hoped that the basic principles outlined in the preceding text will clarify and elucidate one of the most important areas needed for laboratory fiscal integrity and its survival in these difficult times for health care providers. The following general principles derived from this article are helpful aids for managers of toxicology laboratories. 1. To manage a cost-effective, efficient toxicology laboratory, several factors must be considered: the laboratory's instrument configuration, test turnaround time needs, the test menu offered, the analytic methods used, the cost of labor based on time expended and the experience and educational level of the staff, and logistics that determine specimen delivery time and costs. 2. There is a wide variation in costs for toxicologic methods, which requires that an analysis of capital (equipment) purchase and operational (test performance) costs be performed to avoid waste, purchase wisely, and determine which tests consume the majority of the laboratory's resources. 3. Toxicologic analysis is composed of many complex steps. Each step must be individually cost-accounted. Screening test results must be confirmed, and the cost for both steps must be included in the cost per reportable result. 4. Total costs will vary in the same laboratory and between laboratories based on differences in salaries paid to technical staff, differences in reagent/supply costs, the number of technical staff needed to operate the analyzer or perform the method, and the inefficient use of highly paid staff to operate the analyzer or perform the method. 5. Since direct test costs vary directly with the type and number of analyzers or methods and are dependent on the operational mode designed by the manufacturer, laboratory managers should construct an actual test-cost data base for instrument or method in use to accurately compare costs using the "bottom-up" approach. 6. Laboratory expenses can be examined from three perspectives: total laboratory, laboratory section, and subsection workstation. The objective is to track all laboratory expenses through each of these levels. 7. In the final analysis, a portion of total laboratory expenses must be allocated to each unit of laboratory output--the billable procedure or, in laboratories where tests are not billed, the tests produced.(ABSTRACT TRUNCATED AT 400 WORDS)

An evolutionary resolution of manipulation conflict.

PubMed

González-Forero, Mauricio

2014-07-01

Individuals can manipulate the behavior of social partners. However, manipulation may conflict with the fitness interests of the manipulated individuals. Manipulated individuals can then be favored to resist manipulation, possibly reducing or eliminating the manipulated behavior in the long run. I use a mathematical model to show that conflicts where manipulation and resistance coevolve can disappear as a result of the coevolutionary process. I find that while manipulated individuals are selected to resist, they can simultaneously be favored to express the manipulated behavior at higher efficiency (i.e., providing increasing fitness effects to recipients of the manipulated behavior). Efficiency can increase to a point at which selection for resistance disappears. This process yields an efficient social behavior that is induced by social partners, and over which the inducing and induced individuals are no longer in conflict. A necessary factor is costly inefficiency. I develop the model to address the evolution of advanced eusociality via maternal manipulation (AEMM). The model predicts AEMM to be particularly likely in taxa with ancestrally imperfect resistance to maternal manipulation. Costly inefficiency occurs if the cost of delayed dispersal is larger than the benefit of exploiting the maternal patch. I discuss broader implications of the process. © 2014 The Author(s). Evolution © 2014 The Society for the Study of Evolution.

An electric beam trawl for the capture of larval lampreys

USGS Publications Warehouse

McLain, Alberton; Dahl, Frederick H.

1968-01-01

The chemicals used to control the sea lamprey, Petromyzon marinus, in the Great Lakes have drastically reduced populations of larval lampreys in tributary streams. These larvicides are too costly and difficult to apply, however, in inland lakes, estuaries, and bays. Populations of sea lampreys in these areas constitute a threat to the refinement of the control. The gear available to locate, ample, and evaluate larval populations in deep water are inefficient. Electric shockers, satisfactory for collecting ammocoetes in streams, are limited to shallow water. The use of mechanical devices such as the Petersen dredge, anchor dredge, and the orange-peel dredge is time consuming, inefficient, and relatively ineffective in providing reliable quantitative evaluation of population size and composition over large areas of bottom. A device was required to sample adequately many areas in a short period of time, regardless of the depth of water. Mobility also was essential to permit operation of the unit in the various Great Lakes and in inland waters. An electrified beam trawl has been developed that most nearly meets these requirements. It has been used successfully to collect larvae of the sea lamprey, American brook lamprey (Lampetra lamottei), northern brook lamprey (Ichthyomyzon fossor), and silver lamprey (I. unicuspis). Effectiveness of the trawl did not appear to differ with species.

Speech-Language Dissociations, Distractibility, and Childhood Stuttering

PubMed Central

Conture, Edward G.; Walden, Tedra A.; Lambert, Warren E.

2015-01-01

Purpose This study investigated the relation among speech-language dissociations, attentional distractibility, and childhood stuttering. Method Participants were 82 preschool-age children who stutter (CWS) and 120 who do not stutter (CWNS). Correlation-based statistics (Bates, Appelbaum, Salcedo, Saygin, & Pizzamiglio, 2003) identified dissociations across 5 norm-based speech-language subtests. The Behavioral Style Questionnaire Distractibility subscale measured attentional distractibility. Analyses addressed (a) between-groups differences in the number of children exhibiting speech-language dissociations; (b) between-groups distractibility differences; (c) the relation between distractibility and speech-language dissociations; and (d) whether interactions between distractibility and dissociations predicted the frequency of total, stuttered, and nonstuttered disfluencies. Results More preschool-age CWS exhibited speech-language dissociations compared with CWNS, and more boys exhibited dissociations compared with girls. In addition, male CWS were less distractible than female CWS and female CWNS. For CWS, but not CWNS, less distractibility (i.e., greater attention) was associated with more speech-language dissociations. Last, interactions between distractibility and dissociations did not predict speech disfluencies in CWS or CWNS. Conclusions The present findings suggest that for preschool-age CWS, attentional processes are associated with speech-language dissociations. Future investigations are warranted to better understand the directionality of effect of this association (e.g., inefficient attentional processes → speech-language dissociations vs. inefficient attentional processes ← speech-language dissociations). PMID:26126203

Market-Based Health Care in Specialty Surgery: Finding Patient-Centered Shared Value.

PubMed

Smith, Timothy R; Rambachan, Aksharananda; Cote, David; Cybulski, George; Laws, Edward R

2015-10-01

: The US health care system is struggling with rising costs, poor outcomes, waste, and inefficiency. The Patient Protection and Affordable Care Act represents a substantial effort to improve access and emphasizes value-based care. Value in health care has been defined as health outcomes for the patient per dollar spent. However, given the opacity of health outcomes and cost, the identification and quantification of patient-centered value is problematic. These problems are magnified by highly technical, specialized care (eg, neurosurgery). This is further complicated by potentially competing interests of the 5 major stakeholders in health care: patients, doctors, payers, hospitals, and manufacturers. These stakeholders are watching with great interest as health care in the United States moves toward a value-based system. Market principles can be harnessed to drive costs down, improve outcomes, and improve overall value to patients. However, there are many caveats to a market-based, value-driven system that must be identified and addressed. Many excellent neurosurgical efforts are already underway to nudge health care toward increased efficiency, decreased costs, and improved quality. Patient-centered shared value can provide a philosophical mooring for the development of health care policies that utilize market principles without losing sight of the ultimate goals of health care, to care for patients.

[How much does the backlog on drug patents cost for health in Brazil?

PubMed

Jannuzzi, Anna Haydée Lanzillotti; Vasconcellos, Alexandre Guimarães

2017-08-21

The backlog in processing patent applications in Brazil has persisted since the enactment of Law 9,279/1996, when the country resumed granting patents on drugs. The agencies responsible for granting such patents, namely the Brazilian National Patent and Trademark Office (INPI) and the Brazilian National Health Surveillance Agency (Anvisa) cite technical and administrative reasons for the backlog. However, little research has focused on the economic impacts for health due to the inefficiency of the Brazilian patent system. The current study thus proposes a methodology to estimate the extent to which government procurement of medicines is burdened by the backlog in drug patent applications. According to the results, a total of more than BRL 14 million (USD 4.5 million) is spent unnecessarily per year by the Federal Government on just one antiretroviral drug due to the extension of the respective patent's life. Measures to resolve this situation are urgently needed in the three branches of government. These include hiring more staff for the INPI, analysis of bills of law under review in the two houses of the Brazilian Congress to amend the Industrial Property Law, and ruling on direct class action claims of unconstitutionality to suppress the legal mechanisms that allow extending the life of patents.

Potential reduction of energy consumption in public university library

NASA Astrophysics Data System (ADS)

Noranai, Z.; Azman, ADF

2017-09-01

Efficient electrical energy usage has been recognized as one of the important factor to reduce cost of electrical energy consumption. Various parties have been emphasized about the importance of using electrical energy efficiently. Inefficient usage of electrical energy usage lead to biggest factor increasing of administration cost in Universiti Tun Hussein Onn Malaysia. With this in view, a project the investigate potential reduction electrical energy consumption in Universiti Tun Hussein Onn Malaysia was carried out. In this project, a case study involving electrical energy consumption of Perpustakaan Tunku Tun Aminah was conducted. The scopes of this project are to identify energy consumption in selected building and to find the factors that contributing to wastage of electrical energy. The MS1525:2001, Malaysian Standard - Code of practice on energy efficiency and use of renewable energy for non-residential buildings was used as reference. From the result, 4 saving measure had been proposed which is change type of the lamp, install sensor, decrease the number of lamp and improve shading coefficient on glass. This saving measure is suggested to improve the efficiency of electrical energy consumption. Improve of human behaviour toward saving energy measure can reduce 10% from the total of saving cost while on building technical measure can reduce 90% from total saving cost.

Evaluation of digital PCR for absolute RNA quantification.

PubMed

Sanders, Rebecca; Mason, Deborah J; Foy, Carole A; Huggett, Jim F

2013-01-01

Gene expression measurements detailing mRNA quantities are widely employed in molecular biology and are increasingly important in diagnostic fields. Reverse transcription (RT), necessary for generating complementary DNA, can be both inefficient and imprecise, but remains a quintessential RNA analysis tool using qPCR. This study developed a Transcriptomic Calibration Material and assessed the RT reaction using digital (d)PCR for RNA measurement. While many studies characterise dPCR capabilities for DNA quantification, less work has been performed investigating similar parameters using RT-dPCR for RNA analysis. RT-dPCR measurement using three, one-step RT-qPCR kits was evaluated using single and multiplex formats when measuring endogenous and synthetic RNAs. The best performing kit was compared to UV quantification and sensitivity and technical reproducibility investigated. Our results demonstrate assay and kit dependent RT-dPCR measurements differed significantly compared to UV quantification. Different values were reported by different kits for each target, despite evaluation of identical samples using the same instrument. RT-dPCR did not display the strong inter-assay agreement previously described when analysing DNA. This study demonstrates that, as with DNA measurement, RT-dPCR is capable of accurate quantification of low copy RNA targets, but the results are both kit and target dependent supporting the need for calibration controls.

Optical slotted circuit switched network: a bandwidth efficient alternative to wavelength-routed network

NASA Astrophysics Data System (ADS)

Li, Yan; Collier, Martin

2007-11-01

Wavelength-routed networks have received enormous attention due to the fact that they are relatively simple to implement and implicitly offer Quality of Service (QoS) guarantees. However, they suffer from a bandwidth inefficiency problem and require complex Routing and Wavelength Assignment (RWA). Most attempts to address the above issues exploit the joint use of WDM and TDM technologies. The resultant TDM-based wavelength-routed networks partition the wavelength bandwidth into fixed-length time slots organized as a fixed-length frame. Multiple connections can thus time-share a wavelength and the grooming of their traffic leads to better bandwidth utilization. The capability of switching in both wavelength and time domains in such networks also mitigates the RWA problem. However, TMD-based wavelength-routed networks work in synchronous mode and strict synchronization among all network nodes is required. Global synchronization for all-optical networks which operate at extremely high speed is technically challenging, and deploying an optical synchronizer for each wavelength involves considerable cost. An Optical Slotted Circuit Switching (OSCS) architecture is proposed in this paper. In an OSCS network, slotted circuits are created to better utilize the wavelength bandwidth than in classic wavelength-routed networks. The operation of the protocol is such as to avoid the need for global synchronization required by TDM-based wavelength-routed networks.

Freeze concentration of dairy products: Phase 2. Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Best, D.E.; Vasavada, K.C.; Woolf, H.

1995-10-01

Conventional dairy industry evaporators convert an estimated 60 billion pounds of milk and whey products annually into dairy powders. However, many evaporators currently used by dairy processors are old and inefficient and damage the dairy powders through heat abuse. This results in lost organoleptic and functional qualities in the finished dairy products. EPRI report EM-5232 indicated that substitution of freeze concentration for evaporation and distillation in all feasible industry applications could save customers $5.5 billion annually, while increasing electric power consumption by 20 billion kWt/yr. EPRI CU-6292 reported on Phase I work, concluding that freeze concentration of dairy products wasmore » technically feasible based on pilot plant studies. The semicommercial-scale Process development units was successfully installed and brought up to 3-A processing standards. This unit achieved continuous runs of up to 510 hours. An expert safety panel affirmed the generally recognized as safe (GRAS) status of freeze-concentrated milk ingredients, which were used in formulating ice cream, cream cheese, milk chocolate, and other products for consumer evaluation. Consumer evaluations documented that the functional and organoleptic properties of reconstituted freeze-concentrated skim milk are equal or superior to those of fresh skim milk, skim milk concentrates, or nonfat dry milk powders.« less

Revitalization of the NASA Langley Research Center's Infrastructure

NASA Technical Reports Server (NTRS)

Weiser, Erik S.; Mastaler, Michael D.; Craft, Stephen J.; Kegelman, Jerome T.; Hope, Drew J.; Mangum, Cathy H.

2012-01-01

The NASA Langley Research Center (Langley) was founded in 1917 as the nation's first civilian aeronautical research facility and NASA's first field center. For nearly 100 years, Langley has made significant contributions to the Aeronautics, Space Exploration, and Earth Science missions through research, technology, and engineering core competencies in aerosciences, materials, structures, the characterization of earth and planetary atmospheres and, more recently, in technologies associated with entry, descent, and landing. An unfortunate but inevitable outcome of this rich history is an aging infrastructure where the longest serving building is close to 80 years old and the average building age is 44 years old. In the current environment, the continued operation and maintenance of this aging and often inefficient infrastructure presents a real challenge to Center leadership in the trade space of sustaining infrastructure versus not investing in future capabilities. To address this issue, the Center has developed a forward looking revitalization strategy that ties future core competencies and technical capabilities to the Center Master Facility Plan to maintain a viable Center well into the future. This paper documents Langley's revitalization strategy which integrates the Center's missions, the Langley 2050 vision, the Center Master Facility Plan, and the New Town repair-by-replacement program through the leadership of the Vibrant Transformation to Advance Langley (ViTAL) Team.

Solid waste management in Kolkata, India: Practices and challenges

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hazra, Tumpa; Goel, Sudha

2009-01-15

This paper presents an overview of current solid waste management (SWM) practices in Kolkata, India and suggests solutions to some of the major problems. More than 2920 ton/d of solid waste are generated in the Kolkata Municipal Corporation (KMC) area and the budget allocation for 2007-2008 was Rs. 1590 million (US$40 million), which amounts to Rs. 265/cap-y (US$6.7/cap-d) on SWM. This expenditure is insufficient to provide adequate SWM services. Major deficiencies were found in all elements of SWM. Despite 70% of the SWM budget being allocated for collection, collection efficiency is around 60-70% for the registered residents and less thanmore » 20% for unregistered residents (slum dwellers). The collection process is deficient in terms of manpower and vehicle availability. Bin capacity provided is adequate but locations were found to be inappropriate, thus contributing to the inefficiency of the system. At this time, no treatment is provided to the waste and waste is dumped on open land at Dhapa after collection. Lack of suitable facilities (equipment and infrastructure) and underestimates of waste generation rates, inadequate management and technical skills, improper bin collection, and route planning are responsible for poor collection and transportation of municipal solid wastes.« less

Urbanization, cities, and health: The challenges to Nigeria - A review.

PubMed

Aliyu, Alhaji A; Amadu, Lawal

2017-01-01

The Nigerian society is rapidly becoming urban as a result of a multitude of push and pull factors. This has generated urban health crises among city dwellers notably the urban poor. A systematic search of published literature in English was conducted between 1960 and 2015. Published peer review journals, abstracts, Gray literature (technical reports, government documents, reports, etc.), inaugural lectures, and internet articles were reviewed. Manual search of reference lists of selected articles were checked for further relevant studies. The review showed that the pace of urbanization is unprecedented with cities such as Lagos having annual urban growth rate of 5.8%. Urbanization in Nigeria is mainly demographically driven without commensurate socioeconomic dividends and benefits to the urban environment. This has created urban health crises of inadequate water safe supply, squalor and shanty settlements, sanitation, solid waste management, double burden of diseases and inefficient, congested, and risky transport system. In conclusion, when managed carefully, urbanization could reduce hardship and human suffering; on the other hand, it could also increase poverty and squalor. Some laws need to be amended to change the status of poor urban settlements. Urban health development requires intersectoral approach with political will and urban renewal program to make our urban societies sustainable that promote healthy living.

Micro/Nano Fabricated Solid-State Thermoelectric Generator Devices for Integrated High Voltage Power Sources

NASA Astrophysics Data System (ADS)

Fleurial, J.-P.; Ryan, M. A.; Snyder, G. J.; Huang, C.-K.; Whitacre, J. F.; Patel, J.; Lim, J.; Borshchevsky, A.

2002-01-01

Deep space missions have a strong need for compact, high power density, reliable and long life electrical power generation and storage under extreme temperature conditions. Except for electrochemical batteries and solar cells, there are currently no available miniaturized power sources. Conventional power generators devices become inefficient in extreme environments (such as encountered in Mars, Venus or outer planet missions) and rechargeable energy storage devices can only be operated in a narrow temperature range thereby limiting mission duration. The planned development of much smaller spacecrafts incorporating a variety of micro/nanodevices and miniature vehicles will require novel, reliable power technologies. It is also expected that such micro power sources could have a wide range of terrestrial applications, in particular when the limited lifetime and environmental limitations of batteries are key factors. Advanced solid-state thermoelectric combined with radioisotope or waste heat sources and low profile energy storage devices are ideally suited for these applications. The Jet Propulsion Laboratory has been actively pursuing the development of thermoelectric micro/nanodevices that can be fabricated using a combination of electrochemical deposition and integrated circuit processing techniques. Some of the technical challenges associated with these micro/nanodevice concepts, their expected level of performance and experimental fabrication and testing results to date are presented and discussed.

Urbanization, Cities, and Health: The Challenges to Nigeria – A Review

PubMed Central

Aliyu, Alhaji A.; Amadu, Lawal

2017-01-01

The Nigerian society is rapidly becoming urban as a result of a multitude of push and pull factors. This has generated urban health crises among city dwellers notably the urban poor. A systematic search of published literature in English was conducted between 1960 and 2015. Published peer review journals, abstracts, Gray literature (technical reports, government documents, reports, etc.), inaugural lectures, and internet articles were reviewed. Manual search of reference lists of selected articles were checked for further relevant studies. The review showed that the pace of urbanization is unprecedented with cities such as Lagos having annual urban growth rate of 5.8%. Urbanization in Nigeria is mainly demographically driven without commensurate socioeconomic dividends and benefits to the urban environment. This has created urban health crises of inadequate water safe supply, squalor and shanty settlements, sanitation, solid waste management, double burden of diseases and inefficient, congested, and risky transport system. In conclusion, when managed carefully, urbanization could reduce hardship and human suffering; on the other hand, it could also increase poverty and squalor. Some laws need to be amended to change the status of poor urban settlements. Urban health development requires intersectoral approach with political will and urban renewal program to make our urban societies sustainable that promote healthy living. PMID:29063897

Model of Coastal Transit Oriented Development (TOD) Based on the Potential of Local Port and marine Tourism Port, Case Study: Fort Rotterdam Makassar and the Surrounding Areas

NASA Astrophysics Data System (ADS)

Arief, A. B.; Yudono, A.; Akil, A.; Ramli, I.

2017-08-01

The lack of social and public facilties of seven small islands around Makassar, causing the commuters to experience inefficiency in fulfilling their basic needs in the mainland of Makassar city. The purpose of this study is finding the location of coastal TOD in accordance with the principles of development model of coastal TOD. The result showed that inefficiency of time, cost and distance could be eliminated by applying vertical, united and integrated development model of coastal TOD. Using survey, interview and literature study through expert system analysis based on GIS deliniates coastal TOD.

Integrating Public Health and Personal Care in a Reformed US Health Care System

PubMed Central

Chernichovsky, Dov

2010-01-01

Compared with other developed countries, the United States has an inefficient and expensive health care system with poor outcomes and many citizens who are denied access. Inefficiency is increased by the lack of an integrated system that could promote an optimal mix of personal medical care and population health measures. We advocate a health trust system to provide core medical benefits to every American, while improving efficiency and reducing redundancy. The major innovation of this plan would be to incorporate existing private health insurance plans in a national system that rebalances health care spending between personal and population health services and directs spending to investments with the greatest long-run returns. PMID:20019310

Dynamic Constraint Satisfaction with Reasonable Global Constraints

NASA Technical Reports Server (NTRS)

Frank, Jeremy

2003-01-01

Previously studied theoretical frameworks for dynamic constraint satisfaction problems (DCSPs) employ a small set of primitive operators to modify a problem instance. They do not address the desire to model problems using sophisticated global constraints, and do not address efficiency questions related to incremental constraint enforcement. In this paper, we extend a DCSP framework to incorporate global constraints with flexible scope. A simple approach to incremental propagation after scope modification can be inefficient under some circumstances. We characterize the cases when this inefficiency can occur, and discuss two ways to alleviate this problem: adding rejection variables to the scope of flexible constraints, and adding new features to constraints that permit increased control over incremental propagation.

A Mutation in PGM2 Causing Inefficient Galactose Metabolism in the Probiotic Yeast Saccharomyces boulardii.

PubMed

Liu, Jing-Jing; Zhang, Guo-Chang; Kong, In Iok; Yun, Eun Ju; Zheng, Jia-Qi; Kweon, Dae-Hyuk; Jin, Yong-Su

2018-05-15

The probiotic yeast Saccharomyces boulardii has been extensively studied for the prevention and treatment of diarrheal diseases, and it is now commercially available in some countries. S. boulardii displays notable phenotypic characteristics, such as a high optimal growth temperature, high tolerance against acidic conditions, and the inability to form ascospores, which differentiate S. boulardii from Saccharomyces cerevisiae The majority of prior studies stated that S. boulardii exhibits sluggish or halted galactose utilization. Nonetheless, the molecular mechanisms underlying inefficient galactose uptake have yet to be elucidated. When the galactose utilization of a widely used S. boulardii strain, ATCC MYA-796, was examined under various culture conditions, the S. boulardii strain could consume galactose, but at a much lower rate than that of S. cerevisiae While all GAL genes were present in the S. boulardii genome, according to analysis of genomic sequencing data in a previous study, a point mutation (G1278A) in PGM2 , which codes for phosphoglucomutase, was identified in the genome of the S. boulardii strain. As the point mutation resulted in the truncation of the Pgm2 protein, which is known to play a pivotal role in galactose utilization, we hypothesized that the truncated Pgm2 might be associated with inefficient galactose metabolism. Indeed, complementation of S. cerevisiae PGM2 in S. boulardii restored galactose utilization. After reverting the point mutation to a full-length PGM2 in S. boulardii by Cas9-based genome editing, the growth rates of wild-type (with a truncated PGM2 gene) and mutant (with a full-length PGM2 ) strains with glucose or galactose as the carbon source were examined. As expected, the mutant (with a full-length PGM2 ) was able to ferment galactose faster than the wild-type strain. Interestingly, the mutant showed a lower growth rate than that of the wild-type strain on glucose at 37°C. Also, the wild-type strain was enriched in the mixed culture of wild-type and mutant strains on glucose at 37°C, suggesting that the truncated PGM2 might offer better growth on glucose at a higher temperature in return for inefficient galactose utilization. Our results suggest that the point mutation in PGM2 might be involved in multiple phenotypes with different effects. IMPORTANCE Saccharomyces boulardii is a probiotic yeast strain capable of preventing and treating diarrheal diseases. However, the genetics and metabolism of this yeast are largely unexplored. In particular, molecular mechanisms underlying the inefficient galactose metabolism of S. boulardii remain unknown. Our study reports that a point mutation in PGM2 , which codes for phosphoglucomutase, is responsible for inferior galactose utilization by S. boulardii After correction of the mutated PGM2 via genome editing, the resulting strain was able to use galactose faster than a parental strain. While the PGM2 mutation made the yeast use galactose slowly, investigation of the genomic sequencing data of other S. boulardii strains revealed that the PGM2 mutation is evolutionarily conserved. Interestingly, the PGM2 mutation was beneficial for growth at a higher temperature on glucose. We speculate that the PGM2 mutation was enriched due to selection of S. boulardii in the natural habitat (sugar-rich fruits in tropical areas). Copyright © 2018 American Society for Microbiology.

Developing an SSAC Self-Assessment Tool for Operators and Regulators

DOE Office of Scientific and Technical Information (OSTI.GOV)

Frazar, Sarah L.; Innes-Jones, Gemma; Hamilton, Ian

Enabling an SSAC to understand why it is performing inefficiently can help it allocate resources more effectively to better support IAEA safeguards implementation. In collaboration with international consulting firm, Environmental Resources Management (ERM) and a U.S. based nuclear fuel cycle facility, the Pacific Northwest National Laboratory (PNNL) has been developing a framework for a future self-assessment tool for nuclear operators and regulators. This paper will describe the effort to date, with particular emphasis on the steps the team took to align the framework with relevant IAEA self-assessment tools.

Power-Aware Intrusion Detection in Mobile Ad Hoc Networks

NASA Astrophysics Data System (ADS)

Şen, Sevil; Clark, John A.; Tapiador, Juan E.

Mobile ad hoc networks (MANETs) are a highly promising new form of networking. However they are more vulnerable to attacks than wired networks. In addition, conventional intrusion detection systems (IDS) are ineffective and inefficient for highly dynamic and resource-constrained environments. Achieving an effective operational MANET requires tradeoffs to be made between functional and non-functional criteria. In this paper we show how Genetic Programming (GP) together with a Multi-Objective Evolutionary Algorithm (MOEA) can be used to synthesise intrusion detection programs that make optimal tradeoffs between security criteria and the power they consume.

Measuring the performance of Internet companies using a two-stage data envelopment analysis model

NASA Astrophysics Data System (ADS)

Cao, Xiongfei; Yang, Feng

2011-05-01

In exploring the business operation of Internet companies, few researchers have used data envelopment analysis (DEA) to evaluate their performance. Since the Internet companies have a two-stage production process: marketability and profitability, this study employs a relational two-stage DEA model to assess the efficiency of the 40 dot com firms. The results show that our model performs better in measuring efficiency, and is able to discriminate the causes of inefficiency, thus helping business management to be more effective through providing more guidance to business performance improvement.

'Lean' approach gives greater efficiency.

PubMed

Call, Roger

2014-02-01

Adapting the 'Lean' methodologies used for many years by many manufacturers on the production line - such as in the automotive industry - and deploying them in healthcare 'spaces' can, Roger Call, an architect at Herman Miller Healthcare in the US, argues, 'easily remedy many of the inefficiencies' found within a healthcare facility. In an article that first appeared in the September 2013 issue of The Australian Hospital Engineer, he explains how 'Lean' approaches such as the 'Toyota production system', and 'Six Sigma', can be harnessed to good effect in the healthcare sphere.

77 FR 60140 - Notice of Proposed Information Collection; Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-02

... renewed approval for the collection of information for two technical training program course effectiveness... of information contained in two technical training program course effectiveness evaluation forms. OSM... days in which to comment on the following information collection activities: Title: Technical Training...

Inefficient Metabolism of the Human Milk Oligosaccharides Lacto-N-tetraose and Lacto-N-neotetraose Shifts Bifidobacterium longum subsp. infantis Physiology

PubMed Central

Özcan, Ezgi; Sela, David A.

2018-01-01

Human milk contains a high concentration of indigestible oligosaccharides, which likely mediated the coevolution of the nursing infant with its gut microbiome. Specifically, Bifidobacterium longum subsp. infantis (B. infantis) often colonizes the infant gut and utilizes these human milk oligosaccharides (HMOs) to enrich their abundance. In this study, the physiology and mechanisms underlying B. infantis utilization of two HMO isomers lacto-N-tetraose (LNT) and lacto-N-neotetraose (LNnT) was investigated in addition to their carbohydrate constituents. Both LNT and LNnT utilization induced a significant shift in the ratio of secreted acetate to lactate (1.7–2.0) in contrast to the catabolism of their component carbohydrates (~1.5). Inefficient metabolism of LNnT prompts B. infantis to shunt carbon toward formic acid and ethanol secretion. The global transcriptome presents genomic features differentially expressed to catabolize these two HMO species that vary by a single glycosidic linkage. Furthermore, a measure of strain-level variation exists between B. infantis isolates. Regardless of strain, inefficient HMO metabolism induces the metabolic shift toward formic acid and ethanol production. Furthermore, bifidobacterial metabolites reduced LPS-induced inflammation in a cell culture model. Thus, differential metabolism of milk glycans potentially drives the emergent physiology of host-microbial interactions to impact infant health. PMID:29900174

Pabon Lasso and Data Envelopment Analysis: A Complementary Approach to Hospital Performance Measurement

PubMed Central

Mehrtak, Mohammad; Yusefzadeh, Hasan; Jaafaripooyan, Ebrahim

2014-01-01

Background: Performance measurement is essential to the management of health care organizations to which efficiency is per se a vital indicator. Present study accordingly aims to measure the efficiency of hospitals employing two distinct methods. Methods: Data Envelopment Analysis and Pabon Lasso Model were jointly applied to calculate the efficiency of all general hospitals located in Iranian Eastern Azerbijan Province. Data was collected using hospitals’ monthly performance forms and analyzed and displayed by MS Visio and DEAP software. Results: In accord with Pabon Lasso model, 44.5% of the hospitals were entirely efficient, whilst DEA revealed 61% to be efficient. As such, 39% of the hospitals, by the Pabon Lasso, were wholly inefficient; based on DEA though; the relevant figure was only 22.2%. Finally, 16.5% of hospitals as calculated by Pabon Lasso and 16.7% by DEA were relatively efficient. DEA appeared to show more hospitals as efficient as opposed to the Pabon Lasso model. Conclusion: Simultaneous use of two models rendered complementary and corroborative results as both evidently reveal efficient hospitals. However, their results should be compared with prudence. Whilst the Pabon Lasso inefficient zone is fully clear, DEA does not provide such a crystal clear limit for inefficiency. PMID:24999147

Air Quality Impact of Diffuse and Inefficient Combustion Emissions in Africa (DICE-Africa).

PubMed

Marais, Eloise A; Wiedinmyer, Christine

2016-10-04

Anthropogenic pollution in Africa is dominated by diffuse and inefficient combustion sources, as electricity access is low and motorcycles and outdated cars proliferate. These sources are missing, out-of-date, or misrepresented in state-of-the-science emission inventories. We address these deficiencies with a detailed inventory of Diffuse and Inefficient Combustion Emissions in Africa (DICE-Africa) for 2006 and 2013. Fuelwood for energy is the largest emission source in DICE-Africa, but grows from 2006 to 2013 at a slower rate than charcoal production and use, and gasoline and diesel for motorcycles, cars, and generators. Only kerosene use and gas flaring decline. Increase in emissions from 2006 to 2013 in this work is consistent with trends in satellite observations of formaldehyde and NO 2 , but much slower than the explosive growth projected with a fuel consumption model. Seasonal biomass burning is considered a large pollution source in Africa, but we estimate comparable emissions of black carbon and higher emissions of nonmethane volatile organic compounds from DICE-Africa. Nitrogen oxide (NO x ≡ NO + NO 2 ) emissions are much lower than from biomass burning. We use GEOS-Chem to estimate that the largest contribution of DICE-Africa to annual mean surface fine particulate matter (PM 2.5 ) is >5 μg m -3 in populous Nigeria.

Training directionally selective motion pathways can significantly improve reading efficiency

NASA Astrophysics Data System (ADS)

Lawton, Teri

2004-06-01

This study examined whether perceptual learning at early levels of visual processing would facilitate learning at higher levels of processing. This was examined by determining whether training the motion pathways by practicing leftright movement discrimination, as found previously, would improve the reading skills of inefficient readers significantly more than another computer game, a word discrimination game, or the reading program offered by the school. This controlled validation study found that practicing left-right movement discrimination 5-10 minutes twice a week (rapidly) for 15 weeks doubled reading fluency, and significantly improved all reading skills by more than one grade level, whereas inefficient readers in the control groups barely improved on these reading skills. In contrast to previous studies of perceptual learning, these experiments show that perceptual learning of direction discrimination significantly improved reading skills determined at higher levels of cognitive processing, thereby being generalized to a new task. The deficits in reading performance and attentional focus experienced by the person who struggles when reading are suggested to result from an information overload, resulting from timing deficits in the direction-selectivity network proposed by Russell De Valois et al. (2000), that following practice on direction discrimination goes away. This study found that practicing direction discrimination rapidly transitions the inefficient 7-year-old reader to an efficient reader.

Developing Technical Expertise in Secondary Technical Schools: The Effect of 4C/ID Learning Environments

ERIC Educational Resources Information Center

Sarfo, Frederick K.; Elen, Jan

2007-01-01

In this study, the effectiveness of learning environments, developed in line with the specifications of the four components instructional design model (4C/ID model) and the additional effect of ICT for fostering the development of technical expertise in traditional Ghanaian classrooms, was assessed. The study had a one-by-one-by-two…

The effectiveness of fish oil supplementation in asthmatic rats is limited by an inefficient action on ASM function.

PubMed

Miranda, D T S Z; Zanatta, A L; Dias, B C L; Fogaça, R T H; Maurer, J B B; Donatti, L; Calder, P C; Nishiyama, A

2013-09-01

Episodes of acute exacerbation are the major clinical feature of asthma and therefore represent an important focus for developing novel therapies for this disease. There are many reports that the n-3 fatty acids found in fish oil exert anti-inflammatory effects, but there are few studies of the action of fish oil on airway smooth muscle (ASM) function. In the present investigation, we evaluated the effect of fish oil supplementation on smooth muscle force of contraction in ovalbumin-induced asthmatic Wistar rats, and its consequences on static lung compliance, mucus production, leukocyte chemotaxis and production of proinflammatory cytokines. Fish oil supplementation suppressed the infiltration of inflammatory cells into the lung in asthmatic animals (2.04 ± 0.19 × 10(6) cells vs. 3.33 ± 0.43 × 10(6) cells in the control asthmatic group; P < 0.05). Static lung compliance increased with fish oil supplementation in asthmatic rats (0.640 ± 0.053 mL/cm H2O vs. 0.399 ± 0.043 mL/cm H2O; P < 0.05). However, fish oil did not prevent asthma-associated lung eosinophilia and did not affect the concentrations of tumor necrosis factor-α and interleukin-1β in lung tissue or the proportion of the airways obliterated with mucus. Fish oil had no effect on the force of contraction in asthmatic rats in response to acetylcholine (3.026 ± 0.274 mN vs. 2.813 ± 0.364 mN in the control asthmatic group). In conclusion, although fish oil exerts some benefits in this model of asthma, its effectiveness appears to be limited by an inefficient action on airway smooth muscle function.

Leadership Skills among Technical and Vocational Educators

ERIC Educational Resources Information Center

Zakaria, Nurazyan Zahidah; Jizat, Nor Atikah Md.; Zakaria, Normah

2015-01-01

The purpose of leadership skills among technical and vocational educator are to prepare them towards effective organization. Effective leadership is widely accepted as being a key constituent in achieving organization improvement and to examine. This study aimed to gauge the leadership skills among technical and vocational educators effectiveness…

Emphysema on Thoracic CT and Exercise Ventilatory Inefficiency in Mild-to-Moderate COPD.

PubMed

Jones, Joshua H; Zelt, Joel T; Hirai, Daniel M; Diniz, Camilla V; Zaza, Aida; O'Donnell, Denis E; Neder, J Alberto

2017-04-01

There is growing evidence that emphysema on thoracic computed tomography (CT) is associated with poor exercise tolerance in COPD patients with only mild-to-moderate airflow obstruction. We hypothesized that an excessive ventilatory response to exercise (ventilatory inefficiency) would underlie these abnormalities. In a prospective study, 19 patients (FEV 1 = 82 ± 13%, 12 Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 1) and 26 controls underwent an incremental exercise test. Ventilatory inefficiency was assessed by the ventilation ([Formula: see text]E)/CO 2 output ([Formula: see text]CO 2 ) nadir. Pulmonary blood flow (PBF) in a submaximal test was calculated by inert gas rebreathing. Emphysema was quantified as % of attenuation areas below 950 HU. Patients typically presented with centrilobular emphysema (76.8 ± 10.1% of total emphysema) in the upper lobes (upper/total lung ratio = 0.82 ± 0.04). They had lower peak oxygen uptake ([Formula: see text]O 2 ), higher [Formula: see text]E/[Formula: see text]CO 2 nadir, and greater dyspnea scores than controls (p < 0.05). Lower peak [Formula: see text]O 2 and worse dyspnea were found in patients with higher [Formula: see text]E/[Formula: see text]CO 2 nadirs (≥30). Patients had blunted increases in PBF from rest to iso-[Formula: see text]O 2 exercise (p < 0.05). Higher [Formula: see text]E/[Formula: see text]CO 2 nadir in COPD was associated with emphysema severity (r = 0.63) which, in turn, was related to reduced lung diffusing capacity (r = -0.72) and blunted changes in PBF from rest to exercise (r = -0.69) (p < 0.01). Ventilation "wasted" in emphysematous areas is associated with impaired exercise ventilatory efficiency in mild-to-moderate COPD. Exercise ventilatory inefficiency links structure (emphysema) and function (D L CO) to a key clinical outcome (poor exercise tolerance) in COPD patients with only modest spirometric abnormalities.

77 FR 18716 - Transportation Security Administration Postal Zip Code Change; Technical Amendment

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-28

... organizational changes and it has no substantive effect on the public. DATES: Effective March 28, 2012. FOR... No. 1572-9] Transportation Security Administration Postal Zip Code Change; Technical Amendment AGENCY: Transportation Security Administration, DHS. ACTION: Final rule. SUMMARY: This rule is a technical change to...

Fluid mechanics of electroosmotic flow and its effect on band broadening in capillary electrophoresis.

PubMed

Ghosal, Sandip

2004-01-01

Electroosmotic flow (EOF) usually accompanies electrophoretic migration of charged species in capillary electrophoresis unless special precautions are taken to suppress it. The presence of the EOF provides certain advantages in separations. It is an alternative to mechanical pumps, which are inefficient and difficult to build at small scales, for transporting reagents and analytes on microfluidic chips. The downside is that any imperfection that distorts the EOF profile reduces the separation efficiency. In this paper, the basic facts about EOF are reviewed from the perspective of fluid mechanics and its effect on separations in free solution capillary zone electrophoresis is discussed in the light of recent advances.

Pluralist social constraints on the development of a health care system: the case of Israel.

PubMed

Palley, H A; Yishai, Y; Ever-Hadani, P

1983-01-01

The effectiveness of Israel's health care system is hindered by pluralism, in terms both of its many separate health service institutions and of the particularism of those institutions. Although the health care system provides modern health care to a widely insured population, it does so inefficiently and at unnecessary expense. The lack of vertical and horizontal integration of the health care system has led to problems of fragmentation, duplication, and lack of coordination of services. Because of its limited resources, Israel must work to surmount this pluralism and achieve integrated planning if it is to succeed in providing the efficient and cost-effective care its population needs.

Institutions and poverty.

PubMed

Tebaldi, Edinaldo; Mohan, Ramesh

2010-01-01

This study utilises eight alternative measures of institutions and the instrumental variable method to examine the impacts of institutions on poverty. The estimates show that an economy with a robust system to control corruption, an effective government, and a stable political system will create the conditions to promote economic growth, minimise income distribution conflicts, and reduce poverty. Corruption, ineffective governments, and political instability will not only hurt income levels through market inefficiencies, but also escalate poverty incidence via increased income inequality. The results also imply that the quality of the regulatory system, rule of law, voice and accountability, and expropriation risk are inversely related to poverty but their effect on poverty is via average income rather than income distribution.

Metabolic Syndrome and Antipsychotics: The Role of Mitochondrial Fission/Fusion Imbalance.

PubMed

Del Campo, Andrea; Bustos, Catalina; Mascayano, Carolina; Acuña-Castillo, Claudio; Troncoso, Rodrigo; Rojo, Leonel E

2018-01-01

Second-generation antipsychotics (SGAs) are known to increase cardiovascular risk through several physiological mechanisms, including insulin resistance, hepatic steatosis, hyperphagia, and accelerated weight gain. There are limited prophylactic interventions to prevent these side effects of SGAs, in part because the molecular mechanisms underlying SGAs toxicity are not yet completely elucidated. In this perspective article, we introduce an innovative approach to study the metabolic side effects of antipsychotics through the alterations of the mitochondrial dynamics, which leads to an imbalance in mitochondrial fusion/fission ratio and to an inefficient mitochondrial phenotype of muscle cells. We believe that this approach may offer a valuable path to explain SGAs-induced alterations in metabolic homeostasis.

Metabolic Syndrome and Antipsychotics: The Role of Mitochondrial Fission/Fusion Imbalance

PubMed Central

del Campo, Andrea; Bustos, Catalina; Mascayano, Carolina; Acuña-Castillo, Claudio; Troncoso, Rodrigo; Rojo, Leonel E.

2018-01-01

Second-generation antipsychotics (SGAs) are known to increase cardiovascular risk through several physiological mechanisms, including insulin resistance, hepatic steatosis, hyperphagia, and accelerated weight gain. There are limited prophylactic interventions to prevent these side effects of SGAs, in part because the molecular mechanisms underlying SGAs toxicity are not yet completely elucidated. In this perspective article, we introduce an innovative approach to study the metabolic side effects of antipsychotics through the alterations of the mitochondrial dynamics, which leads to an imbalance in mitochondrial fusion/fission ratio and to an inefficient mitochondrial phenotype of muscle cells. We believe that this approach may offer a valuable path to explain SGAs-induced alterations in metabolic homeostasis. PMID:29740394

Incentivizing Blood Donation: Systematic Review and Meta-Analysis to Test Titmuss’ Hypotheses

PubMed Central

2013-01-01

Objectives: Titmuss hypothesized that paying blood donors would reduce the quality of the blood donated and would be economically inefficient. We report here the first systematic review to test these hypotheses, reporting on both financial and nonfinancial incentives. Method: Studies deemed eligible for inclusion were peer-reviewed, experimental studies that presented data on the quantity (as a proxy for efficiency) and quality of blood donated in at least two groups: those donating blood when offered an incentive, and those donating blood with no offer of an incentive. The following were searched: MEDLINE, EMBASE and PsycINFO using OVID SP, CINAHL via EBSCO and CENTRAL, the Cochrane Library, Econlit via EBSCO, JSTOR Health and General Science Collection, and Google. Results: The initial search yielded 1100 abstracts, which resulted in 89 full papers being assessed for eligibility, of which seven studies, reported in six papers, met the inclusion criteria. The included studies involved 93,328 participants. Incentives had no impact on the likelihood of donation (OR = 1.22 CI 95% 0.91–1.63; p = .19). There was no difference between financial and nonfinancial incentives in the quantity of blood donated. Of the two studies that assessed quality of blood, one found no effect and the other found an adverse effect from the offer of a free cholesterol test (β = 0.011 p < .05). Conclusion: The limited evidence suggests that Titmuss’ hypothesis of the economic inefficiency of incentives is correct. There is insufficient evidence to assess their likely impact on the quality of the blood provided. PMID:24001244

Effects of molybdenum on water utilization, antioxidative defense system and osmotic-adjustment ability in winter wheat (Triticum aestivum) under drought stress.

PubMed

Wu, Songwei; Hu, Chengxiao; Tan, Qiling; Nie, Zhaojun; Sun, Xuecheng

2014-10-01

Molybdenum (Mo), as an essential trace element in plants, plays an essential role in abiotic stress tolerance of plants. To obtain a better understanding of drought tolerance enhanced by Mo, a hydroponic trial was conducted to investigate the effects of Mo on water utilization, antioxidant enzymes, non-enzymatic antioxidants, and osmotic-adjustment products in the Mo-efficient '97003' and Mo-inefficient '97014' under PEG simulated drought stress. Our results indicate that Mo application significantly enhanced Pn, chlorophyll, dry matter, grain yield, biomass, RWC and WUE and decreased Tr, Gs and water loss of wheat under drought stress, suggesting that Mo application improved the water utilization capacity in wheat. The activities of antioxidant enzymes such as superoxide dismutase, peroxidase, catalase, ascorbate peroxidase and the contents of non-enzymatic antioxidants content such as ascorbic acid, reduced glutathione, carotenoid were significantly increased and malonaldehyde contents were decreased by Mo application under PEG simulated drought stress, suggesting that Mo application enhanced the ability of scavenging active oxygen species. The osmotic-adjustment products such as soluble protein, proline and soluble sugar were also increased by Mo application under PEG simulated drought stress, indicating that Mo improved the osmotic adjustment ability in wheat. It is hypothesized that Mo application might improve the drought tolerance of wheat by enhancing water utilization capability and the abilities of antioxidative defense and osmotic adjustment. Similarities and differences between the Mo-efficient and Mo-inefficient cultivars wheat in response to Mo under drought stress are discussed. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

A comparative study of charge transfer inefficiency value and trap parameter determination techniques making use of an irradiated ESA-Euclid prototype CCD

NASA Astrophysics Data System (ADS)

Prod'homme, Thibaut; Verhoeve, P.; Kohley, R.; Short, A.; Boudin, N.

2014-07-01

The science objectives of space missions using CCDs to carry out accurate astronomical measurements are put at risk by the radiation-induced increase in charge transfer inefficiency (CTI) that results from trapping sites in the CCD silicon lattice. A variety of techniques are used to obtain CTI values and derive trap parameters, however they often differ in results. To identify and understand these differences, we take advantage of an on-going comprehensive characterisation of an irradiated Euclid prototype CCD including the following techniques: X-ray, trap pumping, flat field extended pixel edge response and first pixel response. We proceed to a comparative analysis of the obtained results.

Investment under Uncertainty with Manager-Shareholder Conflict

NASA Astrophysics Data System (ADS)

Shibata, Takashi; Nishihara, Michi

2009-09-01

This paper examines investment timing by the manager in a decentralized firm in the presence of asymmetric information. In particular, we extend the agency problem in a real options model to incorporate an audit technology which allows the owner, at a cost, to verify private information. The implied investment triggers include those in three related papers: standard full information model (e.g., McDonald and Siegel, 1986); Grenadier and Wang (2005); Shibata (2009). An increase in the penalty for the manager's false report always reduces inefficiency in the investment triggers, while it does not necessarily reduce inefficiency in the total social welfare. Most importantly, however, the full information investment triggers and total social welfare can be approximated arbitrarily closely by making the penalty sufficiently large.

[Acquisition of medicines in the Seguro Popular: inefficiency and inequity].

PubMed

Murayama-Rendón, Ciro

2011-01-01

In this article presents the main results of an analysis of drug purchases made by all the states in Mexico, with the resources from the Popular Secure to cover the Health Services Univesal Catalog (CAUSES by its Spanish acronym) in the first half of 2009. The conclusion is that at least 50% of drugs keys have been purchased with a 20% extra in the reference price set by the authorities. Also, spending on drugs is low despite the fact that there is budget availability and that it varies widely among States. This provides robust evidence that the model of drug purchasing for the scheme is inefficient from the economic point of view, and inequitable from the social point of view.

Development and performance of electronic acute kidney injury triggers to identify pediatric patients at risk for nephrotoxic medication-associated harm.

PubMed

Kirkendall, E S; Spires, W L; Mottes, T A; Schaffzin, J K; Barclay, C; Goldstein, S L

2014-01-01

Nephrotoxic medication-associated acute kidney injury (NTMx-AKI) is a costly clinical phenomenon and more common than previously recognized. Prior efforts to use technology to identify AKI have focused on detection after renal injury has occurred. Describe an approach and provide a technical framework for the creation of risk-stratifying AKI triggers and the development of an application to manage the AKI trigger data. Report the performance characteristics of those triggers and the refinement process and on the challenges of implementation. Initial manual trigger screening guided design of an automated electronic trigger report. A web-based application was designed to alleviate inefficiency and serve as a user interface and central workspace for the project. Performance of the NTMx exposure trigger reports from September 2011 to September 2013 were evaluated using sensitivity (SN), specificity (SP), positive and negative predictive values (PPV, NPV). Automated reports were created to replace manual screening for NTMx-AKI. The initial performance of the NTMx exposure triggers for SN, SP, PPV, and NPV all were ≥0.78, and increased over the study, with all four measures reaching ≥0.95 consistently. A web-based application was implemented that simplifies data entry and couriering from the reports, expedites results viewing, and interfaces with an automated data visualization tool. Sociotechnical challenges were logged and reported. We have built a risk-stratifying system based on electronic triggers that detects patients at-risk for NTMx-AKI before injury occurs. The performance of the NTMx-exposed reports has neared 100% through iterative optimization. The complexity of the trigger logic and clinical workflows surrounding NTMx-AKI led to a challenging implementation, but one that has been successful from technical, clinical, and quality improvement standpoints. This report summarizes the construction of a trigger-based application, the performance of the triggers, and the challenges uncovered during the design, build, and implementation of the system.

The power of a collaborative relationship between technical assistance providers and community prevention teams: A correlational and longitudinal study

PubMed Central

Chilenski, Sarah M.; Perkins, Daniel F.; Olson, Jonathan; Hoffman, Lesa; Feinberg, Mark E.; Greenberg, Mark; Welsh, Janet; Crowley, D. Max; Spoth, Richard

2015-01-01

Background Historically, effectiveness of community collaborative prevention efforts has been mixed. Consequently, research has been undertaken to better understand the factors that support their effectiveness; theory and some related empirical research suggests that the provision of technical assistance is one important supporting factor. The current study examines one aspect of technical assistance that may be important in supporting coalition effectiveness, the collaborative relationship between the technical assistance provider and site lead implementer. Methods Four and one-half years of data were collected from technical assistance providers and prevention team members from the 14 community prevention teams involved in the PROSPER project. Results Spearman correlation analyses with longitudinal data show that the levels of the collaborative relationship during one phase of collaborative team functioning associated with characteristics of internal team functioning in future phases. Conclusions Results suggest that community collaborative prevention work should consider the collaborative nature of the technical assistance provider – prevention community team relationship when designing and conducting technical assistance activities, and it may be important to continually assess these dynamics to support high quality implementation. PMID:26476860

Education, Technical Progress, and Economic Growth: The Case of Taiwan.

ERIC Educational Resources Information Center

Lin, T.-C.

2003-01-01

Investigates the effect of education and the role of technical progress on economic growth in Taiwan from 1965-2000. Finds that education has a positive and significant effect on growth, but the role of technical progress does not appear to be extraordinarily important. Furthermore, no markedly significant relationships exist between capital and…

Find RAD Partner Programs

EPA Pesticide Factsheets

RAD partner programs help protect the ozone layer and reduce emissions of greenhouse gases by disposing of older, inefficient refrigerated appliances using the best environmental practices and technologies available.

Getting Personal: Individuality, Innovation, and Technical Communication.

ERIC Educational Resources Information Center

Steiner, Carol J.

1999-01-01

Suggests that effective communication between technical and nontechnical people is difficult because technical communication lacks a personal dimension: technical people give up their identity to be considered competent. Argues that a different approach to communication education for scientists, engineers, and technologists is required to equip…

Considering the health care entity C corporation conversion to tax pass-through entity status.

PubMed

Reilly, Robert F

2012-01-01

The double taxation of C corporation income from operations and from the ultimate sale of its assets makes the C corporation an inefficient tax status for many health care entities. At the time of this writing, the changes in the federal tax law that are scheduled to take effect in 2013 will increase this level of double-taxation inefficiency. The owners of a C corporation practice can avoid the C corporation status tax inefficiency by converting the practice to either (1) S corporation status or (2) LLC status. The conversion of the health care C corporation to an S corporation may be accomplished without a current tax cost. However, the conversion of a health care C corporation to an LLC status can result in a current tax at both the corporation level and the shareholder level. Nonetheless, the current conversion tax cost may be less than the future tax cost (1) of operating the practice as a C corporation and incurring double taxation at what may be higher tax rates or (2) of incurring the higher tax cost (or reduced price) on the ultimate disposition of the practice assets and the attendant double taxation of the appreciation in the value of the practice assets. Since individual income tax rates on qualifying dividends from C corporations and on capital gains are currently at very low rates, this may be a good time for C corporation practice owners to consider the costs and benefits of a conversion to either S corporation status or LLC status. The practice owners should consult with their accounting, legal, and valuation advisors in order to consider all of the costs and benefits of a possible corporate tax status conversion. An estimation of both the costs and benefits of the corporate tax status conversion depends on the concluded fair market values of the medical practice, dental practice, or other health care entity assets. And, that practice asset appraisal should encompass all of the practice assets, both tangible assets and intangible assets.

Impact of Medicare Advantage penetration and hospital competition on technical efficiency of nursing care in US intensive care units.

PubMed

Min, Ari; Scott, Linda D; Park, Chang; Vincent, Catherine; Ryan, Catherine J; Lee, Taewha

2018-04-10

This study aimed to evaluate technical efficiency of US intensive care units and determine the effects of environmental factors on technical efficiency in providing quality of nursing care. Data were obtained from the 2014 National Database of Nursing Quality Indicators and the Centers for Medicare and Medicaid Services. Data envelopment analysis was used to estimate technical efficiency for each intensive care unit. Multilevel modeling was used to determine the effects of environmental factors on technical efficiency. Overall, Medicare Advantage penetration and hospital competition in a market did not create pressure for intensive care units to become more efficient by reducing their inputs. However, these 2 environmental factors showed positive influences on technical efficiency in intensive care units with certain levels of technical efficiency. The implications of the study results for management strategies and health policy may vary according to the levels of technical efficiency in intensive care units. Further studies are needed to examine why and how intensive care units with particular levels of technical efficiency are differently affected by certain environmental factors. Copyright © 2018 John Wiley & Sons, Ltd.

Environmental effects of dredging: Methods for the assessment of the genotoxic effects of environmental contaminants. Glossary and references. Technical notes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Honeycutt, M.E.; Jarvis, A.S.; McFarland, V.A.

1995-07-01

This technical note is the third in a series of three that outline and describe the principal methods that have been developed to test the potential of environmental contaminants to cause mutagenic, carcinogenic, and teratogenic effects. The first in this series (EEDP-04-24) describes methods used to discern genotoxic effects at the sub cellular level, while the second (EEDP-04-25) describes methods used to discern genotoxic effects at the cellular and organ/organism level. Recent literature citations for each topic referenced in this series of technical notes are provided in this technical note, in addition to a glossary of terms. The information inmore » these technical notes is intended to provide Corps of Engineers personnel with a working knowledge of the terminology and conceptual basis of genotoxicity testing. To develop an improved understanding of the concepts of genotoxicity, readers are encouraged to review A Primer in Genotoxicity (Jarvis, Reilly, and Lutz 1993), presented in Volume D-93-3 of the Environmental Effects of Dredging information exchange bulletin.« less

NASA/DOD Aerospace Knowledge Diffusion Research Project. Paper 32: A new era in international technical communication: American-Russian collaboration

NASA Technical Reports Server (NTRS)

Flammia, Madelyn; Barclay, Rebecca O.; Pinelli, Thomas E.; Keene, Michael L.; Burger, Robert H.; Kennedy, John M.

1993-01-01

Until the recent dissolution of the Soviet Union, the Communist Party exerted a strict control of access to and dissemination of scientific and technical information (STI). This article presents models of the Soviet-style information society and the Western-style information society and discusses the effects of centralized governmental control of information on Russian technical communication practices. The effects of political control on technical communication are then used to interpret the results of a survey of Russian and U.S. aerospace engineers and scientists concerning the time devoted to technical communication, their collaborative writing practices and their attitudes toward collaboration, the kinds of technical documents they produce and use, their views regarding the appropriate content for an undergraduate technical communication course, and their use of computer technology. Finally, the implications of these findings for future collaboration between Russian and U.S. engineers and scientists are examined.

NASA/DoD Aerospace Knowledge Diffusion Research Project. XXXII - A new era in international technical communication: American-Russian collaboration

NASA Technical Reports Server (NTRS)

Flammia, Madelyn; Barclay, Rebecca O.; Pinelli, Thomas E.; Keene, Michael L.; Burger, Robert H.; Kennedy, John M.

1993-01-01

Until the recent dissolution of the Soviet Union, the Communist Party exerted a strict control of access to and dissemination of scientific and technical information. This article presents models of the Soviet-style information society and the Western-style information society and discusses the effects of centralized governmental control of information on Russian technical communication practices. The effects of political control on technical communication are then used to interpret the results of a survey of Russian and U.S. aerospace engineers and scientists concerning the time devoted to technical communication, their collaborative writing practices and their attitudes toward collaboration, the kinds of technical documents they produce and use, their views regarding the appropriate content for an undergraduate technical communication course, and their use of computer technology. Finally, the implications of these findings for future collaboration between Russian and U.S. engineers and scientists are examined.

Expansion Policy of Secondary Technical Education as a Correlate to the Acquisition of Basic Technical Skills by Students in Cameroon

ERIC Educational Resources Information Center

Efande, Lyonga John

2015-01-01

This study aims at investigating the relationship between the expansion of secondary Technical Education on the acquisition of technical skills by students. Technical Vocational Education and Training (TVET) has been expanding quantitatively yearly without paying enough attention to its adverse effect on quality and the acquisition of the…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Devaney, J.J.

The air pollution problems associated with coal burning are discussed. The movement of the pollutants and their natural removal from the atmosphere are reviewed as are the general inefficiencies at emission control attempts. (AIP)

Find Recycling Facilities Servicing RAD Partners

EPA Pesticide Factsheets

RAD partners help protect the ozone layer and reduce emissions of greenhouse gases by disposing of older, inefficient refrigerated appliances using the best environmental practices and technologies available.

77 FR 10351 - Regulatory Review Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-22

... regulation inefficient, obsolete, contrary to controlling legal precedent, or unduly burdensome; (2... what steps may be necessary to relieve any unnecessary burden, including amendment to or repeal of...

Semantic priming from crowded words.

PubMed

Yeh, Su-Ling; He, Sheng; Cavanagh, Patrick

2012-06-01

Vision in a cluttered scene is extremely inefficient. This damaging effect of clutter, known as crowding, affects many aspects of visual processing (e.g., reading speed). We examined observers' processing of crowded targets in a lexical decision task, using single-character Chinese words that are compact but carry semantic meaning. Despite being unrecognizable and indistinguishable from matched nonwords, crowded prime words still generated robust semantic-priming effects on lexical decisions for test words presented in isolation. Indeed, the semantic-priming effect of crowded primes was similar to that of uncrowded primes. These findings show that the meanings of words survive crowding even when the identities of the words do not, suggesting that crowding does not prevent semantic activation, a process that may have evolved in the context of a cluttered visual environment.

The effect of changing state health policy on hospital uncompensated care.

PubMed

Davidoff, A J; LoSasso, A T; Bazzoli, G J; Zuckerman, S

2000-01-01

This paper examines the effect of changing state policy, such as Medicaid eligibility, payment generosity, and HMO enrollment on provision of hospital uncompensated care. Using national data from the American Hospital Association for the period 1990 through 1995, we find that not-for-profit and public hospitals' uncompensated care levels respond positively to Medicaid payment generosity, although the magnitude of the effect is small. Not-for-profit hospitals respond negatively to Medicaid HMO penetration. Public and for-profit hospitals respond negatively to increases in Medicaid eligibility. Results suggest that public insurance payment generosity is an effective but inefficient policy instrument for influencing uncompensated care among not-for-profit hospitals. Further, in localities with high HMO penetration or high penetration of for-profit hospitals, it may be necessary to establish explicit payments for care of the uninsured.

Technical-tactical analysis of youth olympic taekwondo combat.

PubMed

Tornello, Francesco; Capranica, Laura; Minganti, Carlo; Chiodo, Salvatore; Condello, Giancarlo; Tessitore, Antonio

2014-04-01

The purpose of this study was to define the technical and tactical profiles of official youth taekwondo competitions played under the most recent rules of the International Taekwondo Federation. Tactical actions (i.e., attack, defense, and block), technical executions (from 1- to 4-point scores), kicking legs (i.e., front/rear and right/left), and overall technical effectiveness were investigated in relation to match outcome of semifinal and final competitions (n = 50) of youth (aged 13-14 years) black belt athletes during the Italian Taekwondo Cadet Championship. Differences (p < 0.001) were found among all action typologies (Attack: 50.9 ± 2.2%; Defense: 27.7 ± 1.5%; Block: 21.3 ± 1.6%), with winners showing fewer (p = 0.005) offensive actions and more (p = 0.001) defensive actions with respect to non-winners. Independently from match outcome, technical exchanges showed differences (p < 0.001) for technical executions. Winners resulted more efficient (p < 0.001) for both technical and tactical variables. In general, these findings showed that Cadets tend to adopt an offensive strategy. In considering that the adoption of the new electronic system requires athletes to execute correct technical actions to have a score assigned, coaches should emphasize the effectiveness of scoring techniques and help athletes to effectively improve their defense and counterattack capabilities.

Modeling efficiency at the process level: an examination of the care planning process in nursing homes.

PubMed

Lee, Robert H; Bott, Marjorie J; Gajewski, Byron; Taunton, Roma Lee

2009-02-01

To examine the efficiency of the care planning process in nursing homes. We collected detailed primary data about the care planning process for a stratified random sample of 107 nursing homes from Kansas and Missouri. We used these data to calculate the average direct cost per care plan and used data on selected deficiencies from the Online Survey Certification and Reporting System to measure the quality of care planning. We then analyzed the efficiency of the assessment process using corrected ordinary least squares (COLS) and data envelopment analysis (DEA). Both approaches suggested that there was considerable inefficiency in the care planning process. The average COLS score was 0.43; the average DEA score was 0.48. The correlation between the two sets of scores was quite high, and there was no indication that lower costs resulted in lower quality. For-profit facilities were significantly more efficient than not-for-profit facilities. Multiple studies of nursing homes have found evidence of inefficiency, but virtually all have had measurement problems that raise questions about the results. This analysis, which focuses on a process with much simpler measurement issues, finds evidence of inefficiency that is largely consistent with earlier studies. Making nursing homes more efficient merits closer attention as a strategy for improving care. Increasing efficiency by adopting well-designed, reliable processes can simultaneously reduce costs and improve quality.

Iron Requirement and Iron Uptake from Various Iron Compounds by Different Plant Species

PubMed Central

Christ, Rudolf A.

1974-01-01

The Fe requirements of four monocotyledonous plant species (Avena sativa L., Triticum aestivum L., Oryza sativa L., Zea mays L.) and of three dicotyledonous species (Lycopersicum esculentum Mill., Cucumis sativus L., Glycine maxima (L.) Merr.) in hydroponic cultures were ascertained. Fe was given as NaFe-EDDHA chelate (Fe ethylenediamine di (O-hydroxyphenylacetate). I found that the monocotyledonous species required a substantially higher Fe concentration in the nutrient solution in order to attain optimum growth than did the dicotyledonous species. Analyses showed that the process of iron uptake was less efficient with the monocotyledonous species. When the results obtained by using chelated Fe were compared with those using ionic Fe, it was shown that the inefficient species were equally inefficient in utilizing Fe3+ ions. However, the differences between the efficient and the inefficient species disappeared when Fe2+ was used. This confirms the work of others who postulated that Fe3+ is reduced before uptake of chelated iron by the root. In addition, it was shown that reduction also takes place when Fe is used in ionic form. The efficiency of Fe uptake seems to depend on the efficiency of the root system of the particular plant species in reducing Fe3+. The removal of Fe from the chelate complex after reduction to Fe2+ seems to present no difficulties to the various plant species. PMID:16658933

Inefficient skeletal muscle oxidative function flanks impaired motor neuron recruitment in Amyotrophic Lateral Sclerosis during exercise.

PubMed

Lanfranconi, F; Ferri, A; Corna, G; Bonazzi, R; Lunetta, C; Silani, V; Riva, N; Rigamonti, A; Maggiani, A; Ferrarese, C; Tremolizzo, L

2017-06-07

This study aimed to evaluate muscle oxidative function during exercise in amyotrophic lateral sclerosis patients (pALS) with non-invasive methods in order to assess if determinants of reduced exercise tolerance might match ALS clinical heterogeneity. 17 pALS, who were followed for 4 months, were compared with 13 healthy controls (CTRL). Exercise tolerance was assessed by an incremental exercise test on cycle ergometer measuring peak O 2 uptake ([Formula: see text]O 2peak ), vastus lateralis oxidative function by near infrared spectroscopy (NIRS) and breathing pattern ([Formula: see text]E peak ). pALS displayed: (1) 44% lower [Formula: see text]O 2peak vs. CTRL (p < 0.0001), paralleled by a 43% decreased peak skeletal muscle oxidative function (p < 0.01), with a linear regression between these two variables (r 2  = 0.64, p < 0.0001); (2) 46% reduced [Formula: see text]E peak vs. CTRL (p < 0.0001), achieved by using an inefficient breathing pattern (increasing respiratory frequency) from the onset until the end of exercise. Inefficient skeletal muscle O 2 function, when flanking the impaired motor units recruitment, is a major determinant of pALS clinical heterogeneity and working capacity exercise tolerance. CPET and NIRS are useful tools for detecting early stages of oxidative deficiency in skeletal muscles, disclosing individual impairments in the O 2 transport and utilization chain.

VEEP: A Vehicle Economy, Emissions, and Performance simulation program

NASA Technical Reports Server (NTRS)

Klose, G. J.

1978-01-01

The purpose of the VEEP simulation program was to: (1) predict vehicle fuel economy and relative emissions over any specified driving cycle; (2) calculate various measures of vehicle performance (acceleration, passing manuevers, gradeability, top speed), and (3) give information on the various categories of energy dissipation (rolling friction, aerodynamics, accessories, inertial effects, component inefficiences, etc.). The vehicle is described based on detailed subsystem information and numerical parameters characterizing the components of a wide variety of self-propelled vehicles. Conventionally arranged heat engine powered automobiles were emphasized, but with consideration in the design toward the requirement of other types of vehicles.

Can countries of the WHO African Region wean themselves off donor funding for health?

PubMed

Kirigia, Joses Muthuri; Diarra-Nama, Alimata J

2008-11-01

More than 20% of total health expenditure in 48% of the 46 countries in the WHO African Region is provided by external sources. Issues surrounding aid effectiveness suggest that these countries ought to implement strategies for weaning off aid dependency. This paper broaches the following question: what are some of the strategies that countries of the region can employ to wean off donor funding for health? Five strategies are discussed: reduction in economic inefficiencies; reprioritizing public expenditures; raising additional tax revenues; increased private sector involvement in health development; and fighting corruption.

Fault-tolerant software - Experiment with the sift operating system. [Software Implemented Fault Tolerance computer

NASA Technical Reports Server (NTRS)

Brunelle, J. E.; Eckhardt, D. E., Jr.

1985-01-01

Results are presented of an experiment conducted in the NASA Avionics Integrated Research Laboratory (AIRLAB) to investigate the implementation of fault-tolerant software techniques on fault-tolerant computer architectures, in particular the Software Implemented Fault Tolerance (SIFT) computer. The N-version programming and recovery block techniques were implemented on a portion of the SIFT operating system. The results indicate that, to effectively implement fault-tolerant software design techniques, system requirements will be impacted and suggest that retrofitting fault-tolerant software on existing designs will be inefficient and may require system modification.

Postoperative Pulmonary Atelectasis and Collapse, and its Prophylaxis with Intravenous Bicarbonate

PubMed Central

O'Driscoll, M.

1970-01-01

Of 181 patients undergoing major abdominal surgery 116 developed chest complications associated with a metabolic acidosis, low Pco2, depressed tidal volume, increased respiratory rate, but no increase in minute volume. In a matched group of 116 patients given intravenous bicarbonate postoperatively only 15 developed chest complications. This suggests that respiratory physiological dead space decreases in patients with pulmonary collapse and atelectasis following surgery. Acidotic respiration proved inefficient in the postoperative period, and intravenous bicarbonate had a very pronounced effect on the tidal and minute volumes of acidotic patients with pulmonary collapse and atelectasis. PMID:5470431

Hospital cost-containment strategies that earn the respect of rating agencies.

PubMed

Dopoulos, Jason

2016-01-01

To confirm that hospitals have the necessary structures and strategies in place to reduce costs and secure future market share, credit rating agencies analyze a variety of quantitative and qualitative criteria, including: Salaries and benefits, bad debt, age of plant and depreciation, and other line items that may point to inefficiencies in a hospital's expense structure. Cost-benefit analyses, strategic plans, and leadership qualities that show the long-term value of expense cuts, capital investments, and mergers and acquisitions. Cost-effective and clinically appropriate shifts in a hospital's outpatient-to-inpatient ratio. Liquidity and market share.

Metal vapor arc switch electromagnetic accelerator technology

NASA Technical Reports Server (NTRS)

Mongeau, P. P.

1984-01-01

A multielectrode device housed in an insulator vacuum vessel, the metal vapor vacuum switch has high power capability and can hold off voltages up to the 100 kilovolt level. Such switches can be electronically triggered and can interrupt or commutate at a zero current crossing. The physics of arc initiation, arc conduction, and interruption are examined, including material considerations; inefficiencies; arc modes; magnetic field effects; passive and forced extinction; and voltage recovery. Heating, electrode lifetime, device configuration, and external circuit configuration are discussed. The metal vapor vacuum switch is compared with SCRs, GTOs, spark gaps, ignitrons, and mechanical breakers.

Health reform through tax reform: a primer.

PubMed

Furman, Jason

2008-01-01

Tax incentives for employer-sponsored insurance and other medical spending cost about $200 billion annually and have pervasive effects on coverage and costs. This paper surveys a range of proposals to reform health care, either by adding new tax incentives or by limiting or replacing the existing tax incentives. Replacing the current tax preference for insurance with an income-related, refundable tax credit has the potential to expand coverage and reduce inefficient spending at no net federal cost. But such an approach by itself would entail substantial risks, so complementary reforms to the insurance market are essential to ensure success.

How to hold an effective meeting.

PubMed

Koshy, Kiron; Liu, Alison; Whitehurst, Katharine; Gundogan, Buket; Al Omran, Yasser

2017-06-01

Meetings are a common occurrence in academic and medical life. However, most of these meetings will be under-productive and inefficient uses of time. In this article, we provide valuable tips on how best to plan a meeting and get the most out of the people in attendance. This includes how to assess whether a meeting is necessary and what form this meeting should take. In addition to this, guidance is divided into before, during, and after the meeting. This guide will provide structure to your meetings and improve the output you and your team gain from them.