# pos

id: cord-271094-utpg9p5u
pos: NNP
token:
  coresight.com/research/us-online-grocery-survey-2020-many-more-shoppersbuying-more-categories-from-more-retailers/

lemma:
  coresight.com/research/us-online-grocery-survey-2020-many-more-shoppersbuying-more-categories-from-more-retailers/


id: cord-023913-pnjhi8cu
pos: NNP
token:
  http://newsroom.cigna.com/NewsReleases/research-from-cigna-supports-potential-association-between-treated-gum-disease-and-reduced-medical-costs-for-people-with-diabetes

lemma:
  http://newsroom.cigna.com/NewsReleases/research-from-cigna-supports-potential-association-between-treated-gum-disease-and-reduced-medical-costs-for-people-with-diabetes


# ent

id: cord-011701-toevn37u
type: ORG
entity:
  Influenza Pandemic Preparedness Strategy Pandemic Influenza Preparedness and Response A WHO Guidance Document Department of Health and Human Services


id: cord-013244-d6saaiu9
type: CHEMICAL
entity:
  Sofosbuvir Ledipasvir Sofosbuvir Grazoprevir Elbasvir Velpatasvir Sofosbuvir Daclatasvir Ombitasvir Paritaprevir Ritonavir


id: cord-259809-7glw6pir
type: ORG
entity:
  World Health Organization Ottawa Charter for Health Promotion Health Promotion World Health Organization


id: cord-259809-7glw6pir
type: ORG
entity:
  Methods for the Economic Evaluation of Health Care Programmes World Health Organization Handbook for National Quality Policy and Strategy A Practical Approach for Developing Policy and Strategy


id: cord-000916-b22s00es
type: DISEASE
entity:
  influenza A H5N1 in poultry in South East Asia 14 and recent experimental results which have shown that the A H5N1 virus


id: cord-000916-b22s00es
type: DISEASE
entity:
  influenza A H5N1 virus between ferrets Experimental adaptation of an influenza H5 HA confers respiratory droplet transmission


id: cord-271094-utpg9p5u
type: DNA
entity:
  I4 0 Era SYMPHONYA Emerg The development of the hierarchy of effects an historical perspective Search Engine


id: cord-320228-vbzceozs
type: ORG
entity:
  Shanghai Institutions of Higher Learning Shanghai Recruitment Program of Global Experts the National Nature Science of China


id: cord-280718-hlyo4fys
type: WORK_OF_ART
entity:
  Reducing Readmissions after Pancreatectomy Limiting Complications and Coordinating the Care Continuum Adaptation and Implementation of a Transitional Care Protocol for Patients Undergoing Complex Abdominal Surgery Improving Patient Centered Transitional Care after Complex Abdominal Surgery Adaptation of a Transitional Care Protocol to Reduce Readmissino after Complex Abdominal Surgery Agency for Healthcare Research and Quality


id: cord-280718-hlyo4fys
type: DISEASE
entity:
  dehiscence urinary tract infection UTI Clostridium difficile infection pneumonia pulmonary embolism stroke myocardial infarction


id: cord-322123-z43vhxg5
type: ORG
entity:
  Australia s Future Health Workforce Psychiatry Department of Health Australian Institute of Health and Welfare Mental


id: cord-322123-z43vhxg5
type: ORG
entity:
  Australian Government Methods for the Economic Evaluation of Health Care Programmes Consolidated Health Economic Evaluation Reporting Standards


id: cord-104431-3rblzyry
type: GGP
entity:
  hepatitis c costs Per cure Fall to Us 32 Per Person American Association for the Study of Liver Disease The Liver Meeting Mycenax Biotech inc lusineX Tocilizumab Mycenax in house


id: cord-252829-gn56tsz3
type: ORG
entity:
  the National Institute for Health Research Collaboration for Leadership in Applied Health Research South London NIHR CLAHRC South London


id: cord-287067-rrsgl377
type: ORG
entity:
  London National Institute for Health and Clinical Excellence Dutch Health Insurance Board Guidelines


id: cord-284813-jck9f7nx
type: WORK_OF_ART
entity:
  Cycling Methods and User Guide on Physical Activity Air Pollution Injuries and Carbon Impact Assessments World Health Organization European Office Welfare


id: cord-284813-jck9f7nx
type: WORK_OF_ART
entity:
  Cycling Methods and User Guide Regions and Cities of the WHO European Region Commit to Safe Mobility and Transport for Urban Populations


id: cord-318982-cbfiqvu5
type: WORK_OF_ART
entity:
  Sustainability in Material Purchasing A Multi Objective Economic Order Quantity Model under Carbon Trading


id: cord-318982-cbfiqvu5
type: ORG
entity:
  Low Carbon Supply Chain A State of The Art Literature Review Optimal Discounting and Replenishment Policies for Perishable Products Low


id: cord-318982-cbfiqvu5
type: ORG
entity:
  Consumers Low Carbon Awareness Food Transport Refrigeration Approaches to Reduce Energy Consumption and Environmental Impacts of Road Transport Sustainable


id: cord-318982-cbfiqvu5
type: EVENT
entity:
  Joint Decisions on Inventory Replenishment and Emission Reduction Investment under Different Emission Regulations Literature


id: cord-028178-77zq31tw
type: PROTEIN
entity:
  pollution macrophage inhibitory factor MIF prion cellular protein PrPC Interleukin 6 IL 6 interleukin 1 receptor


id: cord-182166-x52i7xb4
type: GGP
entity:
  strategic supply chain planning Toward a physical internet meeting the global logistics sustainability grand challenge Parcel logistics hub design The impact of modularity and hyperconnectivity Integrated airline scheduling The two echelon


id: cord-302937-3yivxfi8
type: WORK_OF_ART
entity:
  The Theory of Demand for Health Insurance Effects of a Cost Sharing Exemption on Use of Preventive Services


id: cord-302937-3yivxfi8
type: ORG
entity:
  British Animal Disease Management Memorandum on Prioritization of Home Confinement as Appropriate in Response


id: cord-346984-36ryhc58
type: ORG
entity:
  Ministry of Economy and Finance Ministry of Agriculture Maritime Fisheries Rural Development and Water and Forests


id: cord-023913-pnjhi8cu
type: ORG
entity:
  specialtiesthe American Academy of Family Practice the American Academy of Pediatrics the American Osteopathic Association


id: cord-023913-pnjhi8cu
type: DISEASE
entity:
  diseases often co occur within the same patient and could be considered variable expression complications


# bib

id: cord-000916-b22s00es
title: Economic analysis of pandemic influenza mitigation strategies for five pandemic severity categories
author: Kelso, Joel K
date: 2013-03-08
txt: ./txt/cord-000916-b22s00es.txt
cache: ./cache/cord-000916-b22s00es.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3606600/
doi: 10.1186/1471-2458-13-211
summary:
  This study estimates the effectiveness and total cost (from a societal perspective, with a lifespan time horizon) of a comprehensive range of social distancing and antiviral drug strategies, under a range of pandemic severity categories. For severe pandemics of category 3 (CFR 0.75%) and greater, a strategy combining antiviral treatment and prophylaxis, extended school closure and community contact reduction resulted in the lowest total cost of any strategy, costing $1,584 per person at category 5. For severe pandemics of category 3 (CFR 0.75%) and greater, a strategy combining antiviral treatment and prophylaxis, extended school closure and community contact reduction resulted in the lowest total cost of any strategy, costing $1,584 per person at category 5. Keywords: Pandemic influenza, Economic analysis, Antiviral medication, Social distancing, Pandemic severity, Case fatality ratio Background While the H1N1 2009 virus spread world-wide and was classed as a pandemic, the severity of resulting symptoms, as quantified by morbidity and mortality rates, was lower than that which had previously occurred in many seasonal epidemics [1] [2] [3] .

abstract:
  BACKGROUND: The threat of emergence of a human-to-human transmissible strain of highly pathogenic influenza A(H5N1) is very real, and is reinforced by recent results showing that genetically modified A(H5N1) may be readily transmitted between ferrets. Public health authorities are hesitant in introducing social distancing interventions due to societal disruption and productivity losses. This study estimates the effectiveness and total cost (from a societal perspective, with a lifespan time horizon) of a comprehensive range of social distancing and antiviral drug strategies, under a range of pandemic severity categories. METHODS: An economic analysis was conducted using a simulation model of a community of ~30,000 in Australia. Data from the 2009 pandemic was used to derive relationships between the Case Fatality Rate (CFR) and hospitalization rates for each of five pandemic severity categories, with CFR ranging from 0.1% to 2.5%. RESULTS: For a pandemic with basic reproduction number R(0) = 1.8, adopting no interventions resulted in total costs ranging from $441 per person for a pandemic at category 1 (CFR 0.1%) to $8,550 per person at category 5 (CFR 2.5%). For severe pandemics of category 3 (CFR 0.75%) and greater, a strategy combining antiviral treatment and prophylaxis, extended school closure and community contact reduction resulted in the lowest total cost of any strategy, costing $1,584 per person at category 5. This strategy was highly effective, reducing the attack rate to 5%. With low severity pandemics costs are dominated by productivity losses due to illness and social distancing interventions, whereas higher severity pandemic costs are dominated by healthcare costs and costs arising from productivity losses due to death. CONCLUSIONS: For pandemics in high severity categories the strategies with the lowest total cost to society involve rigorous, sustained social distancing, which are considered unacceptable for low severity pandemics due to societal disruption and cost.


id: cord-002586-gilnlwms
author: Nahar, Nazmun
date: 2017-06-26
txt: ./txt/cord-002586-gilnlwms.txt
cache: ./cache/cord-002586-gilnlwms.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5485710/
doi: 10.1186/s13104-017-2549-1
summary:
  METHODS: We implemented a behavior change communication intervention in two districts, testing different approaches to reduce the risk of NiV transmission using community mobilization, interpersonal communication, posters and TV public service announcements on local television during the 2012–2014 sap harvesting seasons. Based on previous pilot studies on interrupting bats access to sap [8] [9] [10] , and on the Government of Bangladesh''s recommendation to abstain from drinking raw sap, we developed and implemented a behavior change communication intervention using two different approaches to reduce the risk of NiV transmission. The objective of our paper is to describe and calculate the cost of an already implemented behavior change communication intervention, and estimate the cost of scaling it up to districts where NiV spillover was identified in Bangladesh, using risk-based scenarios. To implement an "only safe sap" intervention with community meetings, gachhi training, poster and the TV public service announcement in the six districts with 48% of all spillover would cost $715,000.

title:
  A large-scale behavior change intervention to prevent Nipah transmission in Bangladesh: components and costs

abstract:
  BACKGROUND: Nipah virus infection (NiV) is a bat-borne zoonosis transmitted to humans through consumption of NiV-contaminated raw date palm sap in Bangladesh. The objective of this analysis was to measure the cost of an NiV prevention intervention and estimate the cost of scaling it up to districts where spillover had been identified. METHODS: We implemented a behavior change communication intervention in two districts, testing different approaches to reduce the risk of NiV transmission using community mobilization, interpersonal communication, posters and TV public service announcements on local television during the 2012–2014 sap harvesting seasons. In one district, we implemented a “no raw sap” approach recommending to stop drinking raw date palm sap. In another district, we implemented an “only safe sap” approach, recommending to stop drinking raw date palm sap but offering the option of drinking safe sap. This is sap covered with a barrier, locally called bana, to interrupt bats’ access during collection. We conducted surveys among randomly selected respondents two months after the intervention to measure the proportion of people reached. We used an activity-based costing method to calculate the cost of the intervention. RESULTS: The implementation cost of the “no raw sap” intervention was $30,000 and the “only safe sap” intervention was $55,000. The highest cost was conducting meetings and interpersonal communication efforts. The lowest cost was broadcasting the public service announcements on local TV channels. To scale up a similar intervention in 30 districts where NiV spillover has occurred, would cost between $2.6 and $3.5 million for one season. Placing the posters would cost $96,000 and only broadcasting the public service announcement through local channels in 30 districts would cost $26,000. CONCLUSIONS: Broadcasting a TV public service announcement is a potential low cost option to advance NiV prevention. It could be supplemented with posters and targeted interpersonal communication, in districts with a high risk of NiV spillover. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13104-017-2549-1) contains supplementary material, which is available to authorized users.


id: cord-004925-fj068j67
author: Morin, B. R.
date: 2017-09-29
txt: ./txt/cord-004925-fj068j67.txt
cache: ./cache/cord-004925-fj068j67.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7087673/
doi: 10.1007/s10393-017-1270-9
summary:
  Since private disease risk mitigation efforts reflect the costs of illness and illness avoidance, interventions that change those costs are also among the options available to public health authorities . Of the many intervention options open to public health authorities-quarantine, social distancing measures such as school closures, vaccination campaigns and so on-we focus on instruments that change risk mitigation by changing the private cost of illness. For R 0 (b) [ [0.95, 1.91] , the optimal public health authority intervention involves an increase in the private cost of illness-a ''tax'' on illness that will stimulate higher levels of private disease risk mitigation. For diseases where infectiousness is either very low (R 0 (b) < 0.941) or very high (i.e., R 0 (b) > 1.91), the optimal public health authority intervention involves a reduction in the cost of illness-a ''subsidy'' on illness that lowers private diseaserisk mitigation effort (Fig. 1) .

title:
  Economic Incentives in the Socially Optimal Management of Infectious Disease: When [Formula: see text] is Not Enough

abstract:
  Does society benefit from encouraging or discouraging private infectious disease-risk mitigation? Private individuals routinely mitigate infectious disease risks through the adoption of a range of precautions, from vaccination to changes in their contact with others. Such precautions have epidemiological consequences. Private disease-risk mitigation generally reduces both peak prevalence of symptomatic infection and the number of people who fall ill. At the same time, however, it can prolong an epidemic. A reduction in prevalence is socially beneficial. Prolongation of an epidemic is not. We find that for a large class of infectious diseases, private risk mitigation is socially suboptimal—either too low or too high. The social optimum requires either more or less private mitigation. Since private mitigation effort depends on the cost of mitigation and the cost of illness, interventions that change either of these costs may be used to alter mitigation decisions. We model the potential for instruments that affect the cost of illness to yield net social benefits. We find that where a disease is not very infectious or the duration of illness is short, it may be socially optimal to promote private mitigation effort by increasing the cost of illness. By contrast, where a disease is highly infectious or long lasting, it may be optimal to discourage private mitigation by reducing the cost of disease. Society would prefer a shorter, more intense, epidemic to a longer, less intense epidemic. There is, however, a region in parameter space where the relationship is more complicated. For moderately infectious diseases with medium infectious periods, the social optimum depends on interactions between prevalence and duration. Basic reproduction numbers are not sufficient to predict the social optimum.


id: cord-006226-fn7zlutj
author: nan
date: 1994
txt: ./txt/cord-006226-fn7zlutj.txt
cache: ./cache/cord-006226-fn7zlutj.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7100636/
doi: 10.1007/bf00193489
abstract: nan
summary:
  The following were analysed: heart rate (HR, bpm), pre-ejection time (PEP, ms), ejection time (VET, ms), HR-corrected electromechanical systole (QS2c, ms), impedance-cardiographic estimates of stroke volume (SV, ml), cardiac output (CO, I/min) and peripheral resistance (TPR, dyn.s.cm -5) calculated from CO and mean blood pressure (SBP and DBP according to auscultatory Korotkoff-I and -IV sounds This indicates that 1) about half the rise of HR and CO and half the shortening of PEP is 131-respectively 1~2-determined, 2) that predominant 132-adrenergic responses, whilst not affecting VET, take optimal benefit from the inodilatory enhancement of pump performance, 3) that an additional 131-adrenergic stimulation is proportionally less efficient, as VET is dramatically shortened, thus blunting the gain in SV so that the rise in CO relies substantially on the amplified increase of HR and 4), VET is more sensitive than QS2c in expressing additional 131-adrenoceptor agonism and 5) prime systolic time intervals provide a less speculative and physiologically more meaningful represenation of cardiac pump dynamics than HR-corrected ones.

title:
  Abstracts of the 4th annual meeting of the German Society of Clinical Pharmacology and Therapy: Hannover, 14–17 September 1994


id: cord-011701-toevn37u
author: Venkatesan, Sudhir
date: 2018-06-28
txt: ./txt/cord-011701-toevn37u.txt
cache: ./cache/cord-011701-toevn37u.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7313872/
doi: 10.1093/pubmed/fdy108
summary:
  METHODS: We developed a spreadsheet-based, decision tree model to assess outcomes averted and cost-effectiveness of antiviral treatment for outpatient use from the perspective of the healthcare payer in the UK. CONCLUSIONS: This analysis shows that across pandemic scenarios, antiviral treatment can be cost-saving for population groups at high risk of influenza-related complications. [15] [16] [17] Two meta-analyses of the extant clinical trial data, examining outcomes based on the intention-to-treat-influenza infected (ITTI) approach, found that early NAI treatment (≤48 h of symptom onset) was associated with a risk reduction of 59 18 and 63% 19 for hospital admission in otherwise healthy patients with influenza. We present a spreadsheet-based decision tree model that evaluates the impact of community-based NAI treatment in terms of the averted influenza-related hospitalizations and associated costeffectiveness in a range of pandemic scenarios. We found that community-based NAI treatment would avert a significant proportion of hospitalizations and deaths, particularly in high-risk patients, across the pandemic scenarios we explored in this analysis.

title:
  Antiviral treatment for outpatient use during an influenza pandemic: a decision tree model of outcomes averted and cost-effectiveness

abstract:
  BACKGROUND: Many countries have acquired antiviral stockpiles for pandemic influenza mitigation and a significant part of the stockpile may be focussed towards community-based treatment. METHODS: We developed a spreadsheet-based, decision tree model to assess outcomes averted and cost-effectiveness of antiviral treatment for outpatient use from the perspective of the healthcare payer in the UK. We defined five pandemic scenarios—one based on the 2009 A(H1N1) pandemic and four hypothetical scenarios varying in measures of transmissibility and severity. RESULTS: Community-based antiviral treatment was estimated to avert 14–23% of hospitalizations in an overall population of 62.28 million. Higher proportions of averted outcomes were seen in patients with high-risk conditions, when compared to non-high-risk patients. We found that antiviral treatment was cost-saving across pandemic scenarios for high-risk population groups, and cost-saving for the overall population in higher severity influenza pandemics. Antiviral effectiveness had the greatest influence on both the number of hospitalizations averted and on cost-effectiveness. CONCLUSIONS: This analysis shows that across pandemic scenarios, antiviral treatment can be cost-saving for population groups at high risk of influenza-related complications.


id: cord-012562-diqt998g
author: Wang, Ying
date: 2020-05-20
txt: ./txt/cord-012562-diqt998g.txt
cache: ./cache/cord-012562-diqt998g.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7439291/
doi: 10.1017/s0950268820001120
summary:
  The aim of this study was to determine the most cost-effective strategy for the prevention and control of multidrug-resistant organisms (MDROs) in intensive care units (ICUs) in areas with limited health resources. Hospitals with low-and mid-level budgets and resources need to select and focus on an optimal strategy based on practical cost-effectiveness, rather than implementing a whole host of measures against MDROs. Given the importance of the scientific and rationale prevention strategies for MDROs worldwide, the limited isolation resources in developing countries and the lack of related cost-effectiveness analysis researches, this study aimed to determine the ideal prevention strategy for MDROs in ICUs in areas with limited health resources, based on a decision tree model. The cost-effectiveness analysis of four prevention strategies against MDROs in ICUs was studied in China, a country with limited health resources.

title:
  Determining the ideal prevention strategy for multidrug-resistance organisms in resource-limited countries: a cost-effectiveness analysis study

abstract:
  The aim of this study was to determine the most cost-effective strategy for the prevention and control of multidrug-resistant organisms (MDROs) in intensive care units (ICUs) in areas with limited health resources. The study was conducted in 12 ICUs of four hospitals. The total cost for the prevention of MDROs and the secondary attack rate (SAR) of MDROs for each strategy were collected retrospectively from 2046 subjects from January to December 2017. The average cost-effectiveness ratio (CER), incremental cost-effectiveness ratio (ICER) and cost-effectiveness acceptability curve were calculated. Hand hygiene (HH) had the lowest total cost (2149.6 RMB) and SAR of MDROs (8.8%) while single-room isolation showed the highest cost (33 700.2 RMB) and contact isolation had the highest SAR of MDROs (31.8%). The average cost per unit infection prevention was 24 427.8 RMB, with the HH strategy followed by the environment disinfection strategy (CER = 21 314.67). HH had the highest iterative cost effect under willingness to pay less than 2000 RMB. Due to the low cost for repeatability and obvious effectiveness, we conclude that HH is the optimal strategy for MDROs infections in ICUs in developing countries. The cost-effectiveness of the four prevention strategies provides some reference for developing countries but multiple strategies remain to be examined.


id: cord-013244-d6saaiu9
author: Eijsink, Job F. H.
date: 2020-10-16
txt: ./txt/cord-013244-d6saaiu9.txt
cache: ./cache/cord-013244-d6saaiu9.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7561704/
doi: 10.1007/s10198-020-01236-2
summary:
  However, it is conceivable that in the near future DAA treatment of HCV-infected women during pregnancy becomes available, not only to limit disease progression in the patient, but also to prevent vertical transmission of the virus to the child. A screening model linked to HCV-disease states within a Markov model was used to evaluate the cost-effectiveness (CE) of HCV screening of pregnant women, with initial treatment during pregnancy, compared to current practice (no screening and no intervention) from a health-care payer perspective in the Netherlands. We subsequently determined the cost-effectiveness and budget impact of HCV screening and treatment among the four cohorts of pregnant women following the different scenarios and comparisons. Our present study demonstrates that HCV screening of pregnant women and subsequent immediate treatment of all HCV-positive individuals with DAAs is a cost-effective intervention in the Netherlands.

title:
  Cost-effectiveness of hepatitis C virus screening, and subsequent monitoring or treatment among pregnant women in the Netherlands

abstract:
  BACKGROUND: The prevalence of diagnosed chronic hepatitis C virus (HCV) infection among pregnant women in the Netherlands is 0.26%, yet many cases remain undiagnosed. HCV screening and treatment of pregnant HCV carriers could reduce the burden of disease and limit vertical transmission from mother to child. We assessed the impact of HCV screening and subsequent treatment with new direct-acting antivirals (DAAs) among pregnant women in the Netherlands. METHODS: An HCV natural history Markov transition state model was developed, to evaluate the public-health and economic impact of HCV screening and treatment. Besides all 179,000 pregnant women in the Netherlands (cohort 1), we modelled 3 further cohorts: all 79,000 first-time pregnant women (cohort 2), 33,000 pregnant migrant women (cohort 3) and 16,000 first-time pregnant migrant women (cohort 4). Each cohort was analyzed in various scenarios: i no intervention, i.e., the current practice, ii screen-and-treat, i.e., the most extensive approach involving treatment of all individuals found HCV-positive, and iii screen-and-treat/monitor, i.e., a strategy involving treatment of symptomatic (F1–F4) patients and follow-up of asymptomatic (F0) HCV carriers with subsequent treatment only at progression. RESULTS: For all cohorts, comparison between scenarios (ii) and (i) resulted in ICERs between €9,306 and €10,173 per QALY gained and 5 year budget impacts varying between €6,283,830 and €19,220,405. For all cohorts, comparison between scenarios (iii) and (i) resulted in ICERs between €1,739 and €2,749 per QALY gained and budget impacts varying between €1,468,670 and €5,607,556. For all cohorts, the ICERs (scenario iii versus ii) involved in delayed treatment of asymptomatic (F0) HCV carriers varied between €56,607 and €56,892, well above the willingness-to-pay (WTP) threshold of €20,000 per QALY gained and even above a threshold of €50,000 per QALY gained. CONCLUSION: Universal screening for HCV among all pregnant women in the Netherlands is cost-effective. However, it would be reasonable to consider smaller risk groups in view of the budget impact of the intervention. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s10198-020-01236-2) contains supplementary material, which is available to authorized users.


id: cord-018497-oy7hsrpt
title: Economic aspects of vaccines and vaccination: a global perspective
author: Beutels, Philippe P.A.
date: 2005
txt: ./txt/cord-018497-oy7hsrpt.txt
cache: ./cache/cord-018497-oy7hsrpt.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7123384/
doi: 10.1007/3-7643-7381-4_1
abstract: nan
summary:
  The share of health-care expenditures in the Gross Domestic Product (GDP) of most industrialised countries has increased from 3%-5% in the early sixties to 7%-11% in 2001 (from 5% to 14% in the USA) [1] This rise has been attributed to medical advances (increasing the number and technological complexity of medical interventions), population aging, sociological changes (more, but smaller families and less familial support for the elderly) and insufficient productivity increases in the services sector. Because of the very long time spans over which benefits accrue, the analysis of most vaccination programs is very sensitive to discounting (of costs as well as health effects). It seems clear, though, that the smallpox eradication program and the establishment of the EPI have generated enormous benefits, not only by directly protecting against important vaccine-preventable diseases, but also by providing opportunities for health education and infrastructure in developing countries [30] .


id: cord-021959-1y67126b
title: State-of-the-art cost of capital in hospitality strategic management
author: Madanoglu, Melih
date: 2009-11-16
txt: ./txt/cord-021959-1y67126b.txt
cache: ./cache/cord-021959-1y67126b.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7152268/
doi: 10.1016/b978-0-08-045079-7.00006-5
abstract: nan
summary:
  However, prior to investing in a project, an executive/manager should make three key estimates to ensure the viability of a business project: economic useful life of the asset, future cash flows that the project will generate, and the discount rate that properly accounts for the time value of the capital invested and compensates the investors for the risk they bear by investing in that project ( Olsen et al. These researchers challenged the model by contending that it is difficult to find the right proxy for the market portfolio and that CAPM does not appear to accurately reflect the firm size in the cost of equity calculation, and that not all systematic risk factors are reflected in returns of the market portfolio.


id: cord-023913-pnjhi8cu
title: Broader Considerations of Medical and Dental Data Integration
author: Foreman, Stephen
date: 2011-10-08
txt: ./txt/cord-023913-pnjhi8cu.txt
cache: ./cache/cord-023913-pnjhi8cu.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177026/
doi: 10.1007/978-1-4471-2185-5_4
summary:
  So while there has been no shortage of effort paid to improving Medicare, the one common theme in all of the recent initiatives is that dental care has been conspicuously 1 A new study by Hedlund, Jeffcoat, Genco and Tanna funded by CIGNA of patients with Type II diabetes and periodontal disease found that medical costs of patients who received maintenance therapy were $2483.51 per year lower than patients who did not. Examples of integrated care models do exist, such as that presented by (Heuer 2007 ) involving school-linked and school-based clinics with an "innovative health infrastructure." According to Heuer, "Neighborhood Outreach Action for Health (NOAH)" is staffed by two nurse practitioners and a part-time physician to provide "primary medical services to more than 3,200 uninsured patients each year" in Scottsdale, Arizona.

abstract:
  Dental health insurance coverage in the United States is either nonexistent (Medicare and the uninsured), spotty (Medicaid) and limited (most employer-based private benefit plans). Perhaps as a result, dental health in the United States is not good. What public policy makers may not appreciate is that this may well be impacting medical care costs in a way that improved dental benefits would produce a substantial return to investment in expanded dental insurance coverage.


id: cord-026169-j4navhku
title: Towards Multi-perspective Conformance Checking with Aggregation Operations
author: Zhang, Sicui
date: 2020-05-18
txt: ./txt/cord-026169-j4navhku.txt
cache: ./cache/cord-026169-j4navhku.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7274327/
doi: 10.1007/978-3-030-50146-4_17
summary:
  Given an event log, i.e., a log file tracking data related to activities performed during process executions, conformance checking techniques are able to pinpoint discrepancies (aka, deviations) between the log and the corresponding model. However, the previous work used basic strategy of standard conformance checking techniques for dealing with multiple constraints deviations; namely, the total degree of data deviations of that activity is computed by summing up the costs for all the violated constraints. With respect to previous work, the approach brings two main contributions: a) it applies fuzzy aggregation operators to assess the level of deviation severity for a set of constraints, and b) it allows to customize the tolerance to deviations of multiple constraints. In this work, we investigated the use of fuzzy aggregation operations in conformance checking of process executions to deal with multiple data constraints for an activity.

abstract:
  Conformance checking techniques are widely adopted to validate process executions against a set of constraints describing the expected behavior. However, most approaches adopt a crisp evaluation of deviations, with the result that small violations are considered at the same level of significant ones. Furthermore, in the presence of multiple data constraints the overall deviation severity is assessed by summing up each single deviation. This approach easily leads to misleading diagnostics; furthermore, it does not take into account user’s needs, that are likely to differ depending on the context of the analysis. We propose a novel methodology based on the use of aggregation functions, to assess the level of deviation severity for a set of constraints, and to customize the tolerance to deviations of multiple constraints.


id: cord-026990-d3l1sbeb
title: Economic menace of diabetes in India: a systematic review
author: Oberoi, Sumit
date: 2020-06-17
txt: ./txt/cord-026990-d3l1sbeb.txt
cache: ./cache/cord-026990-d3l1sbeb.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7299136/
doi: 10.1007/s13410-020-00838-z
summary:
  Thus, the present study aims at capturing the evidence from the literature on the cost of diabetes mellitus in India, reviewing the materials and methods used to estimate the costs and, lastly, exploring future research area. Majority of research publications were excluded on the grounds if they (a) did not provide the detailed analysis of how costs were estimated; (b) were conference articles or posters; (c) only presented the costs of diabetes prevention; and (d) were published in non-peer-reviewed journals. (cost for patients with foot complication was ₹19,020/-, also average cost for renal patients Under the north zone, 8 studies were included to calculate both direct and indirect costs of diabetes at the individual/household level (Fig. 1) . Therefore, the findings of the present study suggest that per annum median direct and indirect cost of diabetes at the individual/household level is very colossal in India.

abstract:
  AIM: Diabetes mellitus is recognised as a major chronic pandemic disease that does not consider any ethnic and monetary background. There is a dearth of literature on the cost of diabetes in the Indian context. Therefore, the present study aims to capture the evidence from the literature on the cost of diabetes mellitus in India. METHODS: An extensive literature was reviewed from ACADEMIA, NCBI, PubMed, ProQuest, EBSCO, Springer, JSTOR, Scopus and Google Scholar. The eligibility criterion is based on ‘PICOS’ procedure, and only those studies which are available in the English language, published between 1999 and February 2019, indexed in ABDC, EBSCO, ProQuest, Scopus and peer-reviewed journals are included. RESULTS: A total of thirty-two studies were included in the present study. The result indicates that the median direct cost of diabetes was estimated to be ₹18,890/- p.a. for the north zone, ₹10,585/- p.a. for the south zone, ₹45,792/- p.a. for the north-east zone and ₹8822/- p.a. for the west zone. Similarly, the median indirect cost of diabetes was ₹18,146/- p.a. for the north zone, ₹1198/- p.a. for the south zone, ₹18,707/- p.a. for the north-east and ₹3949/- p.a. for the west zone. CONCLUSION: The present study highlighted that diabetes poses a high economic burden on individuals/households. The study directed the need to arrange awareness campaign regarding diabetes and associated risk factors in order to minimise the burden of diabetes. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s13410-020-00838-z) contains supplementary material, which is available to authorized users.


id: cord-028178-77zq31tw
title: Urbanicity mental costs valuation: a review and urban-societal planning consideration
author: D’Acci, Luca S.
date: 2020-06-30
txt: ./txt/cord-028178-77zq31tw.txt
cache: ./cache/cord-028178-77zq31tw.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7325640/
doi: 10.1007/s11299-020-00235-3
summary:
  (2004) of 68 studies found a schizophrenia incidence rate 2 times higher in urban areas than in mixed rural/urban areas; a rate that rises up to a 2.75 times greater risk of schizophrenia when one has lived 15 years of her early life in a capital city rather than a rural area (Pedersen and Mortensen 2001a) . 2012 ) used different methods (although non comparable among each other) to estimate mental disorders costs: (1) direct and indirect costs by human capital approach (the standard cost-of-illness method), (2) impact on economic growth (macroeconomic simulation), and (3) value of statistical life (willingness to pay). Let''s speculate that by planning better structural-infrastructural urban environments and forms (D''Acci 2020) and their socio-economic systems/life styles, (eliminating crowd-congestion, pollution, greenless, noise, crime, overwork, stress, over-pace…) of our current cities we are also able to entirely reduce their extra psychosis incidences and then levelling the urban psychosis rate to the rural one.

abstract:
  Living in cities has numerous comparative advantages than living in the countryside or in small villages and towns, most notably better access to education, services and jobs. However, it is also associated with a roughly twofold increase in some mental disorders rate incidence compared with living in rural areas. Economic assessments reported a forecasted loss of more than 19 trillion dollars in global GDP between 2011 and 2030 and of around 7 trillion for the year 2030 alone when measured by the human capital method. If we exclude self-selection processes and make the hypothesis to be able to level down the mental illness rate incidence in urban areas to these of the rural by better urban-societal planning, around € 1.2 trillion could be saved yearly worldwide. Even a reduction of only 20% in urban mental illness rate would save around 250 billion dollars yearly.


id: cord-030926-vtids9ns
title: Trans-boundary commons in infectious diseases
author: Laxminarayan, Ramanan
date: 2016-02-15
txt: ./txt/cord-030926-vtids9ns.txt
cache: ./cache/cord-030926-vtids9ns.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7448792/
doi: 10.1093/oxrep/grv030
summary:
  Emerging threats to global health, including drug-resistant pathogens, emerging pandemics, and outbreaks, represent global trans-boundary commons problems where the actions of individual countries have consequences for other countries. Other examples of country-level actions with global consequences include inadequate vaccination coverage; slow progress on disease elimination; failure to report and contain pandemic flu, antibiotic resistance, and counterfeit drugs; and climate-related health threats. More recently, campaigns to eliminate smallpox and eradicate malaria have been built on the idea that infectious disease control depends not just on national priorities but also on the priorities of one''s neighbours and trading partners. Current International Health Regulations, which were first enacted in 1951 and most recently revised in 2005, require countries to report disease outbreaks. Therefore, it is often essential to have cooperative financing mechanisms for global health interventions, whether to eradicate disease, encourage appropriate levels of disease surveillance and reporting, or to reduce the likelihood of drug resistance.

abstract:
  Emerging threats to global health, including drug-resistant pathogens, emerging pandemics, and outbreaks, represent global trans-boundary commons problems where the actions of individual countries have consequences for other countries. Here, we review what economic analysis can offer in countering these problems through the design of interventions that modify the behaviour of institutions and nations in the direction of greatest global good.


id: cord-031702-jik4116j
title: Sustainability of airlines in India with Covid-19: Challenges ahead and possible way-outs
author: Agrawal, Anshu
date: 2020-09-10
txt: ./txt/cord-031702-jik4116j.txt
cache: ./cache/cord-031702-jik4116j.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7481765/
doi: 10.1057/s41272-020-00257-z
summary:
  Fragile to withstand the cyclic momentary shocks of oil price fluctuation, demand flux, declining currency, airlines in India warrants for robust structural changes in their operating strategies, business model, revenue and pricing strategies to survive the long-lasting consequences of Covid-19. According to ICAO united Aviation study, depending upon the duration and intensity of outbreak, control measures and economic and psychological impact, the global Pink cells portray risky zone and green cells represent safe zone as per Altman Z-score airlines industry may witness decline of 33 to 60% seats offered, reduced passenger traffic from 1878 to 3227 million and gross operating revenue loss of approximately USD 244 to 420 million for the year 2020. Table 5 exhibits the degree of operating leverage of four airlines in India and the consequences on the EBITDA of the airlines, with the different expectations of possible decline in sales amid covid impact.

abstract:
  Coronavirus outbreak has been highly disruptive for aviation sector, threatening the survival and sustainability of airlines. Apart from massive losses attributed to suspended operations, industry foresee a grim recession ahead. Restrictive movements, weak tourism, curtailed income, compressed commercial activities and fear psychosis are expected to compress the passenger demand from 30 to 60%, endangering the commercial viability of airlines operation. Fragile to withstand the cyclic momentary shocks of oil price fluctuation, demand flux, declining currency, airlines in India warrants for robust structural changes in their operating strategies, business model, revenue and pricing strategies to survive the long-lasting consequences of Covid-19. Paper attempts to analyze impact of lockdown and covid crisis on airlines in India and possible challenges ahead. Study also suggests the possible way-out for mitigating the expected losses.


id: cord-103621-ts3llerc
author: Wang, Qiang
date: 2020-03-23
txt: ./txt/cord-103621-ts3llerc.txt
cache: ./cache/cord-103621-ts3llerc.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1101/2020.03.20.20039644
doi: 10.1101/2020.03.20.20039644
summary:
  Method The stochastic agent-based model was used to simulate the process of COVID-19 outbreak in scenario I (imported one case) and II (imported four cases) with a series of public health measures, involving the personal protection, isolation-and-quarantine, gathering restriction, and community containment. The strategy including community containment could protect more lives and was cost-effective, when the number of imported cases was no less than 65, or the delay-time of quarantine was more than five days, or the quarantine probability was below 25%, based on current assumptions. In scenario II (table 3) , compared with no intervention, personal protection or gathering restriction was not cost-effectiveness (ICERs > three times of per capita GDP). The threshold analysis showed that program C became cost-effective (ICERs< three times of per capita GDP) comparing to program A when initial cases increased to imported 65 cases (appendix table 6).

title:
  Effectiveness and cost-effectiveness of public health measures to control COVID-19: a modelling study

abstract:
  Background The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was first reported in China, which caused a respiratory disease known as Coronavirus Disease 2019 (COVID-19). Since its discovery, the virus has spread to over 100 countries and claimed more than 4000 deaths. This study aimed to assess the effectiveness and cost-effectiveness of various response public health measures. Method The stochastic agent-based model was used to simulate the process of COVID-19 outbreak in scenario I (imported one case) and II (imported four cases) with a series of public health measures, involving the personal protection, isolation-and-quarantine, gathering restriction, and community containment. The virtual community was constructed following the susceptible-latent-infectious-recovered framework. The epidemiological and economic parameters derived from the previous literature and field investigation. The main outcomes included avoided infectors, cost-effectiveness ratios (CERs), and incremental cost-effectiveness ratios (ICERs). The sensitivity analyses were undertaken to assess uncertainty. Findings In scenario I and II, the isolation-and-quarantine averted 1696 and 1990 humans infected respectively at the cost of US$12 428 and US$58 555, both with negative value of ICERs. The joint strategy of personal protection and isolation-and-quarantine could avert one more case than single isolation-and-quarantine with additional cost of US$ 166 871 and US$180 140 respectively. The effectiveness of isolation-and-quarantine decreased as lowering quarantine probability and increasing delay-time. Especially in scenario II, when the quarantine probability was less than 25%, the number of infections raised sharply; when the quarantine delay-time reached six days, more than a quarter of individuals would be infected in the community. The strategy including community containment could protect more lives and was cost-effective, when the number of imported cases was no less than 65, or the delay-time of quarantine was more than five days, or the quarantine probability was below 25%, based on current assumptions. Interpretation The isolation-and-quarantine was the most cost-effective intervention. However, personal protection and isolation-and-quarantine was the optimal strategy averting more infectors than single isolation-and-quarantine. Certain restrictions should be considered, such as more initial imported cases, longer quarantine delay-time and lower quarantine probability.


id: cord-104095-g6l57s4x
title: Regression to the Tail: Why the Olympics Blow Up
author: Flyvbjerg, Bent
date: 2020-09-28
txt: ./txt/cord-104095-g6l57s4x.txt
cache: ./cache/cord-104095-g6l57s4x.txt
extension: .txt
mime: text/plain
url: https://arxiv.org/pdf/2009.14682v1.pdf
doi: 10.1177/0308518x20958724
summary:
  The paper tests theoretical statistical distributions against empirical data for the costs of the Games, in order to explain the cost risks faced by host cities and nations. Finally, the paper develops measures for good practice in planning and managing the Games, including how to mitigate the extreme risks of the Olympic power law. While conventional thinking is that a lognormal distribution is thin-tailed, because it has all the moments (mean, variance, etc.), it actually behaves like a power law at a σ > 0.4 (Taleb 2020: 139 ff.) , which is the case for our Olympic costs dataset. In sum, we find: (a) convexity is the root cause of the power-law nature and extreme randomness of cost and cost overrun for the Olympics; (b) convexity is strong for the Games, documented by alpha-values smaller than 2, indicating infinite variance; and (c) convexity at the Games is driven by irreversibility, fixed time schedules, misaligned incentives, tight coupling, long planning horizons, and the Eternal Beginner Syndrome.

abstract:
  The Olympic Games are the largest, highest-profile, and most expensive megaevent hosted by cities and nations. Average sports-related costs of hosting are $12.0 billion. Non-sports-related costs are typically several times that. Every Olympics since 1960 has run over budget, at an average of 172 percent in real terms, the highest overrun on record for any type of megaproject. The paper tests theoretical statistical distributions against empirical data for the costs of the Games, in order to explain the cost risks faced by host cities and nations. It is documented, for the first time, that cost and cost overrun for the Games follow a power-law distribution. Olympic costs are subject to infinite mean and variance, with dire consequences for predictability and planning. We name this phenomenon"regression to the tail": it is only a matter of time until a new extreme event occurs, with an overrun larger than the largest so far, and thus more disruptive and less plannable. The generative mechanism for the Olympic power law is identified as strong convexity prompted by six causal drivers: irreversibility, fixed deadlines, the Blank Check Syndrome, tight coupling, long planning horizons, and an Eternal Beginner Syndrome. The power law explains why the Games are so difficult to plan and manage successfully, and why cities and nations should think twice before bidding to host. Based on the power law, two heuristics are identified for better decision making on hosting. Finally, the paper develops measures for good practice in planning and managing the Games, including how to mitigate the extreme risks of the Olympic power law.


id: cord-104431-3rblzyry
title: Minimum costs to manufacture new treatments for COVID-19
author: Hill, Andrew
date: 2020-04-30
txt: ./txt/cord-104431-3rblzyry.txt
cache: ./cache/cord-104431-3rblzyry.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213074/
doi: nan
summary:
  RESULTS: Minimum estimated costs of production were US $0.93/day for remdesivir, $1.45/day for favipiravir, $0.08/day for hydroxychloroquine, $0.02/day for chloroquine, $0.10/day for azithromycin, $0.28/day for lopinavir/ritonavir, $0.39/day for sofosbuvir/daclatasvir and $1.09/day for pirfenidone. large donor organisations such as the global Fund for aiDs, TB and Malaria (gFaTM) and the President''s emergency Plan for aiDs relief (PePFar) order drugs to treat >20 million people with hiV, at prices close to the cost of production [20, 21] . We used all available costing data for each drug aPi found on Panjiva, excluding shipments <1kg in size, alongside the lowest and highest 15% of results based on prices per kg. Minimum costs to manufacture new treatments for cOViD-19 67 Different dosing protocols are being used for hydroxychloroquine, including 600 mg daily in the small, open-label, non-randomised French study by gautret et al.

abstract:
  INTRODUCTION: ‘Repurposing’ existing drugs to treat COVID-19 is vital to reducing mortality and controlling the pandemic. Several promising drugs have been identified and are in various stages of clinical trials globally. If efficacy of these drugs is demonstrated, rapid, mass availability at an affordable cost would be essential to ensuring equity and access especially amongst low- and middle-income economies. METHODS: Minimum costs of production were estimated from the costs of active pharmaceutical ingredients using established methodology, which had good predictive accuracy for medicines for hepatitis C and HIV amongst others. Data were extracted from global export shipment records or analysis of the route of chemical synthesis. The estimated costs were compared with list prices from a range of countries where pricing data were available. RESULTS: Minimum estimated costs of production were US $0.93/day for remdesivir, $1.45/day for favipiravir, $0.08/day for hydroxychloroquine, $0.02/day for chloroquine, $0.10/day for azithromycin, $0.28/day for lopinavir/ritonavir, $0.39/day for sofosbuvir/daclatasvir and $1.09/day for pirfenidone. Costs of production ranged between $0.30 and $31 per treatment course (10–28 days). Current prices of these drugs were far higher than the costs of production, particularly in the US. CONCLUSIONS: Should repurposed drugs demonstrate efficacy against COVID-19, they could be manufactured profitably at very low costs, for much less than current list prices. Estimations for the minimum production costs can strengthen price negotiations and help ensure affordable access to vital treatment for COVID-19 at low prices globally.


id: cord-182166-x52i7xb4
title: Dynamic Pooled Capacity Deployment for Urban Parcel Logistics
author: Faugere, Louis
date: 2020-07-22
txt: ./txt/cord-182166-x52i7xb4.txt
cache: ./cache/cord-182166-x52i7xb4.txt
extension: .txt
mime: text/plain
url: https://arxiv.org/pdf/2007.11270v1.pdf
doi: nan
summary:
  In particular, it proposes a two-stage stochastic optimization model for the access hub dynamic pooled capacity deployment problem with synchronization of underlying operations through travel time estimates, and a solution approach based on a rolling horizon algorithm with lookahead and a benders decomposition able to solve large scale instances of a real-sized megacity. This paper studies a novel tactical optimization problem: the dynamic deployment of pooled storage capacity in an urban parcel network operating under space-time uncertainty. (1) the characterization of a new tactical problem for capacity deployment, motivated by dynamic aspects of urban parcel logistics needs, (2) the modeling of the access hub dynamic pooled capacity deployment problem as a two-stage stochastic program with synchronization of underlying operations through travel time estimates, and (3) the design of a solution approach based on a rolling horizon algorithm with lookahead and a benders decomposition able to solve large scale instances of a real-sized megacity.

abstract:
  Last-mile logistics is regarded as an essential yet highly expensive component of parcel logistics. In dense urban environments, this is partially caused by inherent inefficiencies due to traffic congestion and the disparity and accessibility of customer locations. In parcel logistics, access hubs are facilities supporting relay-based last-mile activities by offering temporary storage locations enabling the decoupling of last-mile activities from the rest of the urban distribution chain. This paper focuses on a novel tactical problem: the geographically dynamic deployment of pooled relocatable storage capacity modules in an urban parcel network operating under space-time uncertainty. In particular, it proposes a two-stage stochastic optimization model for the access hub dynamic pooled capacity deployment problem with synchronization of underlying operations through travel time estimates, and a solution approach based on a rolling horizon algorithm with lookahead and a benders decomposition able to solve large scale instances of a real-sized megacity. Numerical results, inspired by the case of a large parcel express carrier, are provided to evaluate the computational performance of the proposed approach and suggest up to 28% last-mile cost savings and 26% capacity savings compared to a static capacity deployment strategy.


id: cord-204060-ddve4mga
title: Robust Screening of COVID-19 from Chest X-ray via Discriminative Cost-Sensitive Learning
author: Li, Tianyang
date: 2020-04-27
txt: ./txt/cord-204060-ddve4mga.txt
cache: ./cache/cord-204060-ddve4mga.txt
extension: .txt
mime: text/plain
url: https://arxiv.org/pdf/2004.12592v2.pdf
doi: nan
summary:
  In this paper, we report our solution, discriminative cost-sensitive learning (DCSL), which should be the choice if the clinical needs the assisted screening of COVID-19 from chest X-rays. In this paper, we propose an innovative discriminative cost-sensitive learning (DCSL) for the robust screening of COVID-19 from chest X-rays. We combine both advances into a deep neural network with end-to-end optimization, successfully achieving fine-grained cost-sensitive screening of COVID-19. To the best of our knowledge, it is the first time that we insightfully view the screening of COVID-19 from chest X-rays as a fine-grained cost-sensitive classification problem. In this study, we introduce a score-level cost-sensitive learning approach based on an expert-provided cost matrix to improve the screening accuracy of COVID-19 from chest X-rays. The proposed discriminative cost-sensitive learning algorithm (DCSL) achieves the highest results on the screen-ing of COVID-19 from chest X-rays.

abstract:
  This paper addresses the new problem of automated screening of coronavirus disease 2019 (COVID-19) based on chest X-rays, which is urgently demanded toward fast stopping the pandemic. However, robust and accurate screening of COVID-19 from chest X-rays is still a globally recognized challenge because of two bottlenecks: 1) imaging features of COVID-19 share some similarities with other pneumonia on chest X-rays, and 2) the misdiagnosis rate of COVID-19 is very high, and the misdiagnosis cost is expensive. While a few pioneering works have made much progress, they underestimate both crucial bottlenecks. In this paper, we report our solution, discriminative cost-sensitive learning (DCSL), which should be the choice if the clinical needs the assisted screening of COVID-19 from chest X-rays. DCSL combines both advantages from fine-grained classification and cost-sensitive learning. Firstly, DCSL develops a conditional center loss that learns deep discriminative representation. Secondly, DCSL establishes score-level cost-sensitive learning that can adaptively enlarge the cost of misclassifying COVID-19 examples into other classes. DCSL is so flexible that it can apply in any deep neural network. We collected a large-scale multi-class dataset comprised of 2,239 chest X-ray examples: 239 examples from confirmed COVID-19 cases, 1,000 examples with confirmed bacterial or viral pneumonia cases, and 1,000 examples of healthy people. Extensive experiments on the three-class classification show that our algorithm remarkably outperforms state-of-the-art algorithms. It achieves an accuracy of 97.01%, a precision of 97%, a sensitivity of 97.09%, and an F1-score of 96.98%. These results endow our algorithm as an efficient tool for the fast large-scale screening of COVID-19.


id: cord-252829-gn56tsz3
author: Higginson, Irene J.
date: 2020-11-03
txt: ./txt/cord-252829-gn56tsz3.txt
cache: ./cache/cord-252829-gn56tsz3.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1186/s12916-020-01768-7
doi: 10.1186/s12916-020-01768-7
summary:
  title: Associations between informal care costs, care quality, carer rewards, burden and subsequent grief: the international, access, rights and empowerment mortality follow-back study of the last 3 months of life (IARE I study) Data: ICrs reported hours and activities, care quality, positive aspects and burdens of caregiving, and completed the Texas Revised Inventory of Grief (TRIG). Multivariable logistic regression analysis explored the association of potential explanatory variables, including IC costs and care quality, on three outcomes: positive aspects and burdens of caregiving, and subsequent grief. Therefore, as part of the International, Access, Rights, and Empowerment (IARE I) study of palliative care in three countries, we aimed to determine and compare the informal care (IC) costs and their associations with selfreported caregiver burden, rewards and subsequent caregiver grief, taking account of care quality, as reported by ICrs. We conducted a mortality follow-back postal survey of key informants (normally relatives and informal carers) of decedents identified by palliative care services in participating hospitals.

title:
  Associations between informal care costs, care quality, carer rewards, burden and subsequent grief: the international, access, rights and empowerment mortality follow-back study of the last 3 months of life (IARE I study)

abstract:
  BACKGROUND: At the end of life, formal care costs are high. Informal care (IC) costs, and their effects on outcomes, are not known. This study aimed to determine the IC costs for older adults in the last 3 months of life, and their relationships with outcomes, adjusting for care quality. METHODS: Mortality follow-back postal survey. Setting: Palliative care services in England (London), Ireland (Dublin) and the USA (New York, San Francisco). Participants: Informal carers (ICrs) of decedents who had received palliative care. Data: ICrs reported hours and activities, care quality, positive aspects and burdens of caregiving, and completed the Texas Revised Inventory of Grief (TRIG). Analysis: All costs (formal, informal) were calculated by multiplying reported hours of activities by country-specific costs for that activity. IC costs used country-specific shadow prices, e.g. average hourly wages and unit costs for nursing care. Multivariable logistic regression analysis explored the association of potential explanatory variables, including IC costs and care quality, on three outcomes: positive aspects and burdens of caregiving, and subsequent grief. RESULTS: We received 767 completed surveys, 245 from London, 282 Dublin, 131 New York and 109 San Francisco. Most respondents were women (70%); average age was 60 years. On average, patients received 66–76 h per week from ICrs for ‘being on call’, 52–55 h for ICrs being with them, 19–21 h for personal care, 17–21 h for household tasks, 15–18 h for medical procedures and 7–10 h for appointments. Mean (SD) IC costs were as follows: USA $32,468 (28,578), England $36,170 (31,104) and Ireland $43,760 (36,930). IC costs accounted for 58% of total (formal plus informal) costs. Higher IC costs were associated with less grief and more positive perspectives of caregiving. Poor home care was associated with greater caregiver burden. CONCLUSIONS: Costs to informal carers are larger than those to formal care services for people in the last three months of life. If well supported ICrs can play a role in providing care, and this can be done without detriment to them, providing that they are helped. Improving community palliative care and informal carer support should be a focus for future investment.


id: cord-254630-ed5gawoj
title: Single-Use (Disposable) Flexible Bronchoscopes: The Future of Bronchoscopy?
author: Barron, Sarah P.
date: 2020-09-17
txt: ./txt/cord-254630-ed5gawoj.txt
cache: ./cache/cord-254630-ed5gawoj.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32944885/
doi: 10.1007/s12325-020-01495-8
summary:
  Additionally, RFBs pose a risk of nosocomial infection transmission between patients with the identification of human proteins, deoxyribonucleic acid (DNA) and pathogenic organisms on fully reprocessed bronchoscopes despite full adherence to the guidelines. Until now, disposable or single-use flexible bronchoscopes (SUFBs) have primarily been used by anaesthetists in an ICU or peri-operative setting where they perform to an acceptable level in comparison to RFBs [12, 13] combined with the distinct advantage of a reduced risk of infection owing to their sterility [14] . In this review, the risk of infection with standard RFBs will be outlined as will the advantages of SUFBs, with comment on their cost profile compared to RFBs and attempt to suggest a rationale for their use during the COVID-19 pandemic and in a respiratory setting.

abstract:
  The coronavirus disease (COVID-19) pandemic has highlighted the importance of reducing occupational exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The reprocessing procedure for reusable flexible bronchoscopes (RFBs) involves multiple episodes of handling of equipment that has been used during an aerosol-generating procedure and thus is a potential source of transmission. Single-use flexible bronchoscopes (SUFBs) eliminate this source. Additionally, RFBs pose a risk of nosocomial infection transmission between patients with the identification of human proteins, deoxyribonucleic acid (DNA) and pathogenic organisms on fully reprocessed bronchoscopes despite full adherence to the guidelines. Bronchoscopy units have been hugely impacted by the pandemic with restructuring of pre- and post-operative areas, altered patient protocols and the reassessment of air exchange and cleaning procedures. SUFBs can be incorporated into these protocols as a means of improving occupational safety. Most studies on the efficacy of SUFBs have occurred in an anaesthetic setting so it remains to be seen whether they will perform to an acceptable standard in complex respiratory procedures such as transbronchial biopsies and cryotherapy. Here, we outline their potential uses in a respiratory setting, both during and after the current pandemic.


id: cord-259809-7glw6pir
author: Lloyd, Helen M.
date: 2020-04-28
txt: ./txt/cord-259809-7glw6pir.txt
cache: ./cache/cord-259809-7glw6pir.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/ijerph17093050
doi: 10.3390/ijerph17093050
summary:
  The COST CARES project aims to support healthcare cost containment and improve healthcare quality across Europe by developing the research and development necessary for person-centred care (PCC) and health promotion. COST Action 15222 ''Cost Cares'' was funded by the EU Commission to create the impetus in both the research and development required to design and test innovative exploratory health laboratories (EHLs) to implement PCC and HP across the EU. Repeated here for clarity the critical enablers are (1) information technology (IT), which describes the use of computers or other computerized devises to store, transmit, and receive data to support PCC planning and care coordination, for handling and communicating health and evaluation data, and for delivering PCC and HP interventions. (4) Incentive systems that reward PCC processes and outcomes, such as personal health goals, PCC plans, improvements in patient self-efficacy and experiences of care, and HP activities.

title:
  Supporting Innovative Person-Centred Care in Financially Constrained Environments: The WE CARE Exploratory Health Laboratory Evaluation Strategy

abstract:
  The COST CARES project aims to support healthcare cost containment and improve healthcare quality across Europe by developing the research and development necessary for person-centred care (PCC) and health promotion. This paper presents an overview evaluation strategy for testing ‘Exploratory Health Laboratories’ to deliver these aims. Our strategy is theory driven and evidence based, and developed through a multi-disciplinary and European-wide team. Specifically, we define the key approach and essential criteria necessary to evaluate initial testing, and on-going large-scale implementation with a core set of accompanying methods (metrics, models, and measurements). This paper also outlines the enabling mechanisms that support the development of the “Health Labs” towards innovative models of ethically grounded and evidenced-based PCC.


id: cord-271094-utpg9p5u
author: Erdmann, Anett
date: 2020-10-20
txt: ./txt/cord-271094-utpg9p5u.txt
cache: ./cache/cord-271094-utpg9p5u.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.techfore.2020.120373
doi: 10.1016/j.techfore.2020.120373
summary:
  Concretely, in the environment of grocery e-commerce (GE) and from a classic economic perspective of evaluation of the optimal marketing budget of Dorfman and Steiner (1954) , which has been adapted by the authors of this research to the nature of digital marketing, an analytical model is proposed which allows to optimize the investment in marketing based on a marginal analysis and respond to a fundamental question in DIM: the analysis of its economic performance. The analysis of the optimal DIM mix of SEO and SEM oriented towards the generation of website traffic is conducted for a total of 29 leading grocery e-commerce firms in Europe (UK, France, Germany, Netherlands, and Norway) and the USA over a time horizon of six years (2014 -2019) at a monthly level to evaluate the relationship between DIM and economic performance.

title:
  Digital inbound marketing: Measuring the economic performance of grocery e-commerce in Europe and the USA

abstract:
  This research investigates the cost-result relationship of the Inbound Marketing actions used by grocery e-commerce. The analysis is based on the application of the Dorfman and Steiner (1954) model for optimal advertising budget, which is adapted by the authors to digital marketing and verified with empirical statistical analysis. Considering 29 leading companies in six countries over a time horizon of six years, an analysis of the mix of SEO and SEM techniques aimed at the attraction and conversion of Internet users to the web pages of their companies is carried out. The results confirm that e-commerce is optimizing Digital Inbound Marketing in line with the established model. Differences are identified depending on the type of format (pure player versus brick and mortar) and at the country level (UK and USA versus others).


id: cord-280718-hlyo4fys
author: Acher, Alexandra W.
date: 2020-07-15
txt: ./txt/cord-280718-hlyo4fys.txt
cache: ./cache/cord-280718-hlyo4fys.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s11605-020-04714-3
doi: 10.1007/s11605-020-04714-3
summary:
  title: Early vs Late Readmissions in Pancreaticoduodenectomy Patients: Recognizing Comprehensive Episodic Cost to Help Guide Bundled Payment Plans and Hospital Resource Allocation INTRODUCTION: Previous studies on readmission cost in pancreaticoduodenectomy patients use estimated cost data and do not delineate etiology or cost differences between early and late readmissions. Early readmission was associated with index stay deep vein thrombosis (p < 0.01), delayed gastric emptying (p < 0.01), and grade B pancreatic fistula (p < 0.01). Bivariate analysis of risk factors for early and late readmissions was based on preoperative patient factors, surgeon, and type of postoperative index stay complication. The high-cost late readmissions were related to time-dependent or chronic postoperative issues, some of which required reoperation: recurrent small bowel obstruction requiring reoperation, DGE, PF-related enterocutaneous fistula, and organ space infection requiring invasive intervention (Fig. 2, Table 3 ).

title:
  Early vs Late Readmissions in Pancreaticoduodenectomy Patients: Recognizing Comprehensive Episodic Cost to Help Guide Bundled Payment Plans and Hospital Resource Allocation

abstract:
  INTRODUCTION: Previous studies on readmission cost in pancreaticoduodenectomy patients use estimated cost data and do not delineate etiology or cost differences between early and late readmissions. We sought to identify relationships between postoperative complication type and readmission timing and cost in pancreaticoduodenectomy patients. METHODS: Hospital cost data from date of discharge to postoperative day 90 were merged with 2008–2018 NSQIP data. Early readmission was within 30 days of surgery, and late readmission was 30 to 90 days from surgery. Regression analyses for readmission controlled for patient comorbidities, complications, and surgeon. RESULTS: Of 230 patients included, 58 (25%) were readmitted. The mean early and late readmission costs were $18,365 ± $20,262 and $24,965 ± $34,435, respectively. Early readmission was associated with index stay deep vein thrombosis (p < 0.01), delayed gastric emptying (p < 0.01), and grade B pancreatic fistula (p < 0.01). High-cost early readmission had long hospital stays or invasive procedures. Common late readmission diagnoses were grade B pancreatic fistula requiring drainage (n = 5, 14%), failure to thrive (n = 4, 14%), and bowel obstruction requiring operation (n = 3, 11%). High-cost late readmissions were associated with chronic complications requiring reoperation. CONCLUSION: Early and late readmissions following pancreaticoduodenectomy differ in both etiology and cost. Early readmission and cost are driven by common complications requiring percutaneous intervention while late readmission and cost are driven by chronic complications and reoperation. Late readmissions are frequent and a significant source of resource utilization. Negotiations of bundled care payment plans should account for significant late readmission resource utilization. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11605-020-04714-3) contains supplementary material, which is available to authorized users.


id: cord-281160-e00koo91
title: A Review of the Role of Cost–Benefit Analyses in 2-1-1 Diffusion
author: Shank, Nancy
date: 2012-12-31
txt: ./txt/cord-281160-e00koo91.txt
cache: ./cache/cord-281160-e00koo91.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0749379712006174
doi: 10.1016/j.amepre.2012.08.020
summary:
  Context The 2-1-1 helpline is a social services innovation that has spread rapidly throughout the U.S. Policy diffusion theory suggests that policymakers seek to reduce uncertainty by anticipating the effects of a proposed innovation through tools such as cost–benefit analyses. 13 United Way Worldwide and AIRS have served as networks for information sharing about the costs and benefıts of 2-1-1, typically by equipping local 2-1-1 supporters who were in contact with their state and local policymakers. AIRS and United Way Worldwide publicized documents and toolkits with information about the service''s costs and benefıts through e-mail discussion groups, at national conferences, and through personal communications. Excluded from the study were analyses not specifıc to 2-1-1, information sources that were not formalized, or that presented costs or benefıts only in a very general way.

abstract:
  Context The 2-1-1 helpline is a social services innovation that has spread rapidly throughout the U.S. Policy diffusion theory suggests that policymakers seek to reduce uncertainty by anticipating the effects of a proposed innovation through tools such as cost–benefit analyses. Few policy diffusion studies have examined use of information, such as cost–benefit analyses, in the diffusion process. The purpose of this study is to examine how cost–benefit analyses were used during the rapid diffusion of 2-1-1 across states. The paper also describes components of 2-1-1 cost–benefit analyses. Evidence acquisition In 2011, cost–benefit analyses of 2-1-1 and substantive citations of them were identified through scholarly key word searches using Academic Search Premier and Web of Science, general Internet searches using Google search terms, and communications with academicians and 2-1-1 practitioners through personal contact and e-mail discussion groups. To be included in this study, documents had to be related to 2-1-1 helplines, present information about their costs and benefits, and be formal documents. The documents were catalogued and analyzed for cost–benefit analyses or references to analyses, and stated purpose. Evidence synthesis Of the 19 documents that met eligibility inclusion criteria, nine were original cost–benefit analyses and ten referenced analyses conducted for other jurisdictions. Conclusions The diffusion of 2-1-1 helplines in the U.S. has been influenced by interjurisdictional exchange of cost–benefit analyses, in both the creation of original analyses and/or the referencing of previous work.


id: cord-282716-gxv6cbom
author: Juneau, Carl-Etienne
date: 2020-04-24
txt: ./txt/cord-282716-gxv6cbom.txt
cache: ./cache/cord-282716-gxv6cbom.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1101/2020.04.20.20054726
doi: 10.1101/2020.04.20.20054726
summary:
  A cautious interpretation of this body of lower-quality evidence suggests that: (1) the most cost-effective interventions are swift contact tracing and case isolation, surveillance networks, protective equipment for healthcare workers, and early vaccination (when available); (2) home quarantines and stockpiling antivirals are less cost-effective; (3) social distancing measures like workplace and school closures are effective but costly, making them the least cost-effective options; (4) combinations are more cost-effective than single interventions; (5) interventions are more cost-effective when adopted early and for severe viruses like SARS-CoV-2. Conclusions: A cautious interpretation of this body of evidence suggests that for COVID-19: (1) social distancing is effective but costly, especially when adopted late and (2) adopting as early as possible a combination of interventions that includes hand washing, face masks, swift contact tracing and case isolation, and protective equipment for healthcare workers is likely to be the most cost-effective strategy.

title:
  Evidence-based, cost-effective interventions to suppress the COVID-19 pandemic: a rapid systematic review

abstract:
  Background: Countries vary in their response to the COVID-19 pandemic. Some emphasise social distancing, while others focus on other interventions. Evidence on the effectiveness and cost-effectiveness of these interventions is urgently needed to guide public health policy and avoid unnecessary damage to the economy and other harms. We aimed to provide a comprehensive summary of the evidence on epidemic control, with a focus on cost-effectiveness. Methods: MEDLINE (1946 to March week 3, 2020) and Embase (1974 to March 27, 2020) were searched using a range of terms related to epidemic control. Reviews, randomized trials, observational studies, and modelling studies were included. Articles reporting on the effectiveness or cost-effectiveness of at least one intervention were included and grouped into higher-quality (randomized trials) and lower-quality evidence (other study designs). Findings: We found 1,653 papers; 34 were included. Higher-quality evidence was only available to support the effectiveness of hand washing and face masks. Modelling studies suggested that these measures are highly cost-effective. For other interventions, only evidence from observational and modelling studies was available. A cautious interpretation of this body of lower-quality evidence suggests that: (1) the most cost-effective interventions are swift contact tracing and case isolation, surveillance networks, protective equipment for healthcare workers, and early vaccination (when available); (2) home quarantines and stockpiling antivirals are less cost-effective; (3) social distancing measures like workplace and school closures are effective but costly, making them the least cost-effective options; (4) combinations are more cost-effective than single interventions; (5) interventions are more cost-effective when adopted early and for severe viruses like SARS-CoV-2. For H1N1 influenza, contact tracing was estimated to be 4,363 times more cost-effective than school closures ($2,260 vs. $9,860,000 per death prevented). Conclusions: A cautious interpretation of this body of evidence suggests that for COVID-19: (1) social distancing is effective but costly, especially when adopted late and (2) adopting as early as possible a combination of interventions that includes hand washing, face masks, swift contact tracing and case isolation, and protective equipment for healthcare workers is likely to be the most cost-effective strategy.


id: cord-284813-jck9f7nx
title: Appraisal of cycling and pedestrian projects
author: Ruffino, Paolo
date: 2020-10-14
txt: ./txt/cord-284813-jck9f7nx.txt
cache: ./cache/cord-284813-jck9f7nx.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S254300092030038X
doi: 10.1016/bs.atpp.2020.08.005
summary:
  Increased planning and financing activity has followed, targeting larger infrastructure projects such as bicycle and pedestrian networks, cycling highways, mass bicycle parking, diffused traffic calming measures and carfree areas, as well as the experimentation of behavioral interventions such as (non) monetary incentives such as bike-to-work or walk-to-school programs (Banister, 1990; Bertolini and le Clercq, 2003; Braun et al., 2016; Martens, 2007; Pucher and Buehler, 2012; Pucher et al., 2010) . In the field of transport appraisal, MCA is the most common alternative to Cost-Benefit Analysis as it allows to consider effects that are typically difficult to quantify and monetize (such as social inclusion, aesthetics, image, equity, etc.) (Browne and Ryan, 2011) . (2009) performed a CEA to measure the health outcomes against the costs of six different physical activity interventions compared to identify the most cost-effective option (the comparison included travel smart programs that rewarded travelers for reducing car trips and choosing to walk and cycle).

abstract:
  Cycling and walking have gained a prominent role in the mobility policy agenda as awareness has risen over the growing unsustainability of the current transport system and the multiple co-benefits of active mobility. As interest and investments for cycling and walking increase, how active mobility can be appraised becomes a crucial question, which has been tackled over the years through different methods and tools. The aim of this chapter is to provide a structured review of the methods and the practices of appraisal of walking and cycling policies and projects, focusing on both traditional and emerging assessment techniques. At present, much attention has been paid to the application of four main traditional methods: Balance Sheet Calculations, Cost-Benefit Analysis, Cost-Effectiveness Analysis and Multi-Criteria Analysis. We compare and discuss these methods to identify strengths and weaknesses for each of them, as well as their main limitations and knowledge gaps in their application. We conclude that over the last decades much effort has been undertaken to further expand and develop these tools thanks to an increased attention to walking and cycling. However, much research is still needed, particularly in the quantification and valuation of specific effects within Cost-Benefit Analysis and in better integrating different appraisal techniques. Finally, the impact of appraisals on decision-making outcomes is still underexplored.


id: cord-287067-rrsgl377
title: Funding of drugs: do vaccines warrant a different approach?
author: Beutels, Philippe
date: 2008-11-30
txt: ./txt/cord-287067-rrsgl377.txt
cache: ./cache/cord-287067-rrsgl377.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S1473309908702585
doi: 10.1016/s1473-3099(08)70258-5
summary:
  2 The individual perception of risks of disease and risks of adverse events drives the demand Panel: Why many vaccines require a diff erent approach • Primary prevention in healthy people, but with possibility of adverse events • Unvaccinated or poorly vaccinated people may experience benefi cial or, more rarely, detrimental impact from herd immunity • Many vaccines prevent short-lived illness in very young children, causing extra family care and work loss, for which evaluation methods lack credibility and acceptability • The cost-eff ectiveness of many vaccines is highly sensitive to the choice of discount method • Some infections are eradicable • Some emerging infections (eg, SARS, pandemic infl uenza) would have a major macroeconomic impact that goes beyond lost productivity of sick people SARS=severe acute respiratory syndrome.

abstract:
  Summary Vaccines have features that require special consideration when assessing their cost-effectiveness. These features are related to herd immunity, quality-of-life losses in young children, parental care and work loss, time preference, uncertainty, eradication, macroeconomics, and tiered pricing. Advisory committees on public funding for vaccines, or for pharmaceuticals in general, should be knowledgable about these special features. We discuss key issues and difficulties in decision making for vaccines against rotavirus, human papillomavirus, varicella-zoster virus, influenza virus, and Streptococcus pneumoniae. We argue that guidelines for economic evaluation should be reconsidered generally to recommend (1) modelling options for the assessment of interventions against infectious diseases; (2) a wider perspective to account for impacts on third parties, if relevant; (3) a wider scope of costs than health-care system costs alone, if appropriate; and (4) alternative discounting techniques to explore social time preference over long periods.


id: cord-287901-56goaqir
author: Maudgil, D.D.
date: 2020-10-17
txt: ./txt/cord-287901-56goaqir.txt
cache: ./cache/cord-287901-56goaqir.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S000992602030427X
doi: 10.1016/j.crad.2020.09.017
summary:
  Costs for the same procedure can vary widely, e.g., the "Getting it Right First Time" (GIRFT) Vascular Surgery report noted that reported cost for elective endovascular aortic repair (EVAR) varied between £2,251 and £19,690 for no apparent reason and with no indication that lower cost procedures were less effective 2,4 ; CES encompass a wider societal perspective than just the clinician''s or patient''s point of view alone, helping demonstrate equitable resource allocation in a publicly funded service 3 ; CES allow evaluation of short-and long-term costs and benefits, which are often under-or overestimated; and 4 CES provide an explicit and accountable framework for decision making, which can be re-examined as data accumulate, particularly important with evolving techniques and experience as in interventional radiology (IR).

title:
  Cost effectiveness and the role of the National Institute of Health and Care Excellence (NICE) in interventional radiology

abstract:
  Healthcare expenditure is continually increasing and projected to accelerate in the future, with an increasing proportion being spent on interventional radiology. The role of cost effectiveness studies in ensuring the best allocation of resources is discussed, and the role of National Institute of Health and Care Excellence (NICE) in determining this. Issues with demonstrating cost effectiveness have been discussed, and it has been found that there is significant scope for improving cost effectiveness, with suggestions made for how this can be achieved. In this way, more patients can benefit from better treatment given limited healthcare budgets.


id: cord-288487-hs3wfffs
author: Lambert, Stephen B
date: 2008-01-24
txt: ./txt/cord-288487-hs3wfffs.txt
cache: ./cache/cord-288487-hs3wfffs.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1186/1465-9921-9-11
doi: 10.1186/1465-9921-9-11
summary:
  The point estimate of the mean cost of community-managed influenza illnesses in healthy preschool aged children is three times greater than those illnesses caused by RSV and other respiratory viruses. Even for influenza, the most studied of all respiratory viruses, cost-of-illness and vaccine cost-effectiveness evaluations in children have tended to rely on assumptions or use retrospectively collected estimates, often from surveys, for resource utilisation, such as carer time away from work in seeking healthcare or caring for an ill child [6] [7] [8] [9] . Despite overlapping confidence intervals, the finding of most note in this study was the dramatically higher point estimate of the mean cost of influenza A ARIs, being three times higher than illnesses caused by RSV and the other common respiratory viral infections of childhood. Further studies that collect primary, integrated epidemiologic and economic data, particularly indirect costs, directly from families about community-managed ARIs in children, are required.

title:
  The cost of community-managed viral respiratory illnesses in a cohort of healthy preschool-aged children

abstract:
  BACKGROUND: Acute respiratory illnesses (ARIs) during childhood are often caused by respiratory viruses, result in significant morbidity, and have associated costs for families and society. Despite their ubiquity, there is a lack of interdisciplinary epidemiologic and economic research that has collected primary impact data, particularly associated with indirect costs, from families during ARIs in children. METHODS: We conducted a 12-month cohort study in 234 preschool children with impact diary recording and PCR testing of nose-throat swabs for viruses during an ARI. We used applied values to estimate a virus-specific mean cost of ARIs. RESULTS: Impact diaries were available for 72% (523/725) of community-managed illnesses between January 2003 and January 2004. The mean cost of ARIs was AU$309 (95% confidence interval $263 to $354). Influenza illnesses had a mean cost of $904, compared with RSV, $304, the next most expensive single-virus illness, although confidence intervals overlapped. Mean carer time away from usual activity per day was two hours for influenza ARIs and between 30 and 45 minutes for all other ARI categories. CONCLUSION: From a societal perspective, community-managed ARIs are a significant cost burden on families and society. The point estimate of the mean cost of community-managed influenza illnesses in healthy preschool aged children is three times greater than those illnesses caused by RSV and other respiratory viruses. Indirect costs, particularly carer time away from usual activity, are the key cost drivers for ARIs in children. The use of parent-collected specimens may enhance ARI surveillance and reduce any potential Hawthorne effect caused by compliance with study procedures. These findings reinforce the need for further integrated epidemiologic and economic research of ARIs in children to allow for comprehensive cost-effectiveness assessments of preventive and therapeutic options.


id: cord-291645-63ftephy
author: Aldridge, Arnie P.
date: 2020-10-03
txt: ./txt/cord-291645-63ftephy.txt
cache: ./cache/cord-291645-63ftephy.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.drugalcdep.2020.108336
doi: 10.1016/j.drugalcdep.2020.108336
summary:
  BACKGROUND: The HEALing Communities Study (HCS) is designed to implement and evaluate the Communities That HEAL (CTH) intervention, a conceptually driven framework to assist communities in selecting and adopting evidence-based practices to reduce opioid overdose deaths. The objectives of the HES are to estimate the economic costs to communities of implementing and sustaining CTH; estimate broader societal costs associated with CTH; estimate the cost-effectiveness of CTH for overdose deaths avoided; and use simulation modeling to evaluate the shortand long-term health and economic impact of CTH, including future overdose deaths avoided and quality-adjusted life years saved, and to develop a simulation policy tool for communities that seek to implement CTH or a similar community intervention. The HCS HES will use simulation modeling to evaluate the short-and long-term health and economic impacts of the CTH intervention and to develop a policy tool for communities that want to implement CTH.

title:
  Health economic design for evaluating cost, cost-effectiveness and simulation analyses in the HEALing Communities Study

abstract:
  BACKGROUND: The HEALing Communities Study (HCS) is designed to implement and evaluate the Communities That HEAL (CTH) intervention, a conceptually driven framework to assist communities in selecting and adopting evidence-based practices to reduce opioid overdose deaths. The goal of the HCS is to produce generalizable information for policy makers and community stakeholders seeking to implement CTH or a similar community intervention. To support this objective, one aim of the HCS is a health economics study (HES), the results of which will inform decisions around fiscal feasibility and sustainability relevant to other community settings. METHODS: The HES is integrated into the HCS design: an unblinded, multisite, parallel arm, cluster randomized, wait list–controlled trial of the CTH intervention implemented in 67 communities in four U.S. states: Kentucky, Massachusetts, New York, and Ohio. The objectives of the HES are to estimate the economic costs to communities of implementing and sustaining CTH; estimate broader societal costs associated with CTH; estimate the cost-effectiveness of CTH for overdose deaths avoided; and use simulation modeling to evaluate the short- and long-term health and economic impact of CTH, including future overdose deaths avoided and quality-adjusted life years saved, and to develop a simulation policy tool for communities that seek to implement CTH or a similar community intervention. DISCUSSION: The HCS offers an unprecedented opportunity to conduct health economics research on solutions to the opioid crisis and to increase understanding of the impact and value of complex, community-level interventions.


id: cord-292349-r2ljahss
title: Cost structure effects of horizontal airline mergers and acquisitions
author: Gudmundsson, Sveinn Vidar
date: 2020-08-27
txt: ./txt/cord-292349-r2ljahss.txt
cache: ./cache/cord-292349-r2ljahss.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.tranpol.2020.08.017
doi: 10.1016/j.tranpol.2020.08.017
summary:
  We offer support that the ex-post cost structure effects of airline M&As depend on the incentives to improve efficiency, reflected in the ex-ante performance of the merging firms. In the background of this literature, we develop our cost structure arguments taking into account different types of M&As guided by specific conditions surrounding target selection and timing that affect the ex-ante performance disparity of the merging firms and therefore efficiency improvement incentives ex-post. Along these arguments we attempt to reveal evidence supporting our prediction that horizontal M&As involving unprofitable firm(s) have stronger management incentive for efficiency improvement ex-post than if both firms are profitable, which is important for competition policy and relevant to regulators approving mergers.

abstract:
  The purpose of this research is to test the ex-post cost structure effects in horizontal mergers and acquisitions (M&A). Our proposed methodology quantifies cost structure effects empirically to inform competition policy around M&As in the airline industry. The results show that horizontal M&As involving unprofitable firms significantly reduce variable costs and increase fixed costs ex-post. M&As involving only profitable firms show no significant impact on the cost structure. We offer support that the ex-post cost structure effects of airline M&As depend on the incentives to improve efficiency, reflected in the ex-ante performance of the merging firms. We further argue that market behavior may not just depend on market structure but cost structures too, all of which should be accounted for in antitrust decision making and regulation around airline M&As.


id: cord-299309-p703e396
author: Tan-Torres Edejer, Tessa
date: 2020-09-09
txt: ./txt/cord-299309-p703e396.txt
cache: ./cache/cord-299309-p703e396.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32918872/
doi: 10.1016/s2214-109x(20)30383-1
summary:
  title: Projected health-care resource needs for an effective response to COVID-19 in 73 low-income and middle-income countries: a modelling study This study aimed to identify what the additional health-care costs of a strategic preparedness and response plan (SPRP) would be if current transmission levels are maintained in a status quo scenario, or under scenarios where transmission is increased or decreased by 50%. Evidence before this study Since Jan 30, 2020, when WHO labelled the COVID-19 pandemic a Public Health Emergency of International Concern, countries have tried to limit its spread, instituting measures on physical distancing and restrictions on movement. As of June 26, 2020, the costs of the full, nine-pillar response to COVID-19 in 73 low-income and middleincome countries after 4 weeks, on July 24, 2020, were projected to be approximately $52 billion, assuming that the Rt was unchanged and the status quo continued.

title:
  Projected health-care resource needs for an effective response to COVID-19 in 73 low-income and middle-income countries: a modelling study

abstract:
  BACKGROUND: Since WHO declared the COVID-19 pandemic a Public Health Emergency of International Concern, more than 20 million cases have been reported, as of Aug 24, 2020. This study aimed to identify what the additional health-care costs of a strategic preparedness and response plan (SPRP) would be if current transmission levels are maintained in a status quo scenario, or under scenarios where transmission is increased or decreased by 50%. METHODS: The number of COVID-19 cases was projected for 73 low-income and middle-income countries for each of the three scenarios for both 4-week and 12-week timeframes, starting from June 26, 2020. An input-based approach was used to estimate the additional health-care costs associated with human resources, commodities, and capital inputs that would be accrued in implementing the SPRP. FINDINGS: The total cost estimate for the COVID-19 response in the status quo scenario was US$52·45 billion over 4 weeks, at $8·60 per capita. For the decreased or increased transmission scenarios, the totals were $33·08 billion and $61·92 billion, respectively. Costs would triple under the status quo and increased transmission scenarios at 12 weeks. The costs of the decreased transmission scenario over 12 weeks was equivalent to the cost of the status quo scenario at 4 weeks. By percentage of the overall cost, case management (54%), maintaining essential services (21%), rapid response and case investigation (14%), and infection prevention and control (9%) were the main cost drivers. INTERPRETATION: The sizeable costs of a COVID-19 response in the health sector will escalate, particularly if transmission increases. Instituting early and comprehensive measures to limit the further spread of the virus will conserve resources and sustain the response. FUNDING: WHO, and UK Foreign Commonwealth and Development Office.


id: cord-302937-3yivxfi8
title: Indemnifying precaution: economic insights for regulation of a highly infectious disease
author: Robertson, Christopher T
date: 2020-05-30
txt: ./txt/cord-302937-3yivxfi8.txt
cache: ./cache/cord-302937-3yivxfi8.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32733690/
doi: 10.1093/jlb/lsaa032
summary:
  For insights, we review health insurance moral hazard, agricultural infectious disease policy, and deterrence theory, but find that classic enforcement strategies of punishing noncompliant people are stymied. Under a strategy of social distancing, lockdown, or quarantine, individuals are directed or suggested to exercise precautions including staying home, closing businesses, wearing masks, and avoiding physical proximity to other persons. 17 For health insurance design, primary moral hazard may have a relatively small effect on risk-taking behavior, because individuals personally suffer many of the other risks associated with illness or injury (including pain, suffering, lost work, chance of death). In this case, although the risk does not approach zero, it is as if relative youth provides partial indemnity insurance against not only the healthcare costs, but also the pain, suffering, lost work, and chance of death that are associated with COVID-19 infection.

abstract:
  Economic insights are powerful for understanding the challenge of managing a highly infectious disease, such as COVID-19, through behavioral precautions including social distancing. One problem is a form of moral hazard, which arises when some individuals face less personal risk of harm or bear greater personal costs of taking precautions. Without legal intervention, some individuals will see socially risky behaviors as personally less costly than socially beneficial behaviors, a balance that makes those beneficial behaviors unsustainable. For insights, we review health insurance moral hazard, agricultural infectious disease policy, and deterrence theory, but find that classic enforcement strategies of punishing noncompliant people are stymied. One mechanism is for policymakers to indemnify individuals for losses associated with taking those socially desirable behaviors to reduce the spread. We develop a coherent approach for doing so, based on conditional cash payments and precommitments by citizens, which may also be reinforced by social norms.


id: cord-318982-cbfiqvu5
title: Sustainable Dynamic Lot Sizing Models for Cold Products under Carbon Cap Policy
author: As''ad, Rami
date: 2020-09-04
txt: ./txt/cord-318982-cbfiqvu5.txt
cache: ./cache/cord-318982-cbfiqvu5.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.cie.2020.106800
doi: 10.1016/j.cie.2020.106800
summary:
  Amid the ever growing interest in operational supply chain models that incorporate environmental aspects as an integral part of the decision making process, this paper addresses the dynamic lot sizing problem of a cold product while accounting for carbon emissions generated during temperature-controlled storage and transportation activities. More specifically, cold or perishable products in general, typically exhibit time varying demand stressing the need for dynamic lot sizing modeling approach to optimize inventory and transportation related decisions on a periodic basis, and accordingly control costs and carbon emissions. The impact of the carbon cap (both total and periodic) as well as other key problem parameters on the lot sizing policy, the operational cost and the carbon footprint generated is assessed in Section 4 through sensitivity analysis. Min TCF(Q) subject to constraints (3) to (11) The upper bound, , is the total carbon emissions of the optimal lot sizing policy of the following carbon cap-unconstrained operational cost optimization problem.

abstract:
  Amid the ever growing interest in operational supply chain models that incorporate environmental aspects as an integral part of the decision making process, this paper addresses the dynamic lot sizing problem of a cold product while accounting for carbon emissions generated during temperature-controlled storage and transportation activities. We present two mixed integer programming models to tackle the two cases where the carbon cap is imposed over the whole planning horizon versus the more stringent version of a cap per period. For the first model, a Lagrangian relaxation approach is proposed which provides a mean for comparing the operational cost and carbon footprint performance of the carbon tax and the carbon cap policies. Subsequently, a Bisection based algorithm is developed to solve the relaxed model and generate the optimal ordering policy. The second model, however, is solved via a dynamic programming based algorithm while respecting two established lower and upper bounds on the periodic carbon cap. The results of the computational experiments for the first model display a stepwise increase (decrease) in the total carbon emissions (operational cost) as the preset cap value is increased. A similar behavior is also observed for the second model with the exception that paradoxical increases in the total emissions are sometimes realized with slightly tighter values of the periodic cap.


id: cord-320228-vbzceozs
title: Post-disaster evacuation and temporary resettlement considering panic and panic spread
author: Hu, Zhi-Hua
date: 2014-11-30
txt: ./txt/cord-320228-vbzceozs.txt
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extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0191261514001398
doi: 10.1016/j.trb.2014.08.004
summary:
  A novel mixed-integer linear program is constructed for multi-step evacuation and temporary resettlement under minimization of panic-induced psychological penalty cost, psychological intervention cost, and costs associated with transportation and building shelters. Third, psychological penalty cost perceived by victims due to wait for evacuation, psychological intervention cost, cost of transporting victims from disaster sites to resettlement sites, and cost of building resettlement shelters are minimized in this formulation. Next, the time-varying strength of panic, and the time-varying costs and limits of shelters and mental health workers are modeled to study the effects of wait times on evacuation and resettlement solutions. Due to urgent demands for mental health workers and temporary shelters, and the marginally increasing degree of panic perceived by victims while waiting for evacuation and resettlement, three parameters (C P t ; C INC t and a t ) are defined as functions of wait times. This study addressed the post-disaster evacuation and temporary resettlement problem for victims affected by psychological penalty induced by panic and panic spread.

abstract:
  Abstract After a disaster, a huge number of homeless victims should be evacuated to temporary resettlement sites. However, because the number of temporary shelters is insufficient, as are shelter building capabilities, victims must be evacuated and resettled in batches. The perceived psychological penalty to victims may increase due to heightened panic when waiting for evacuation and resettlement, whereas psychological interventions can decrease the magnitude of this panic. Based on the susceptible–infective-removal model, panic spread among homeless victims and other disaster-affected people is modeled, while considering the effects of psychological interventions on panic spread. A function is derived to compute the increase in the number of victims to be evacuated due to panic spread. A novel mixed-integer linear program is constructed for multi-step evacuation and temporary resettlement under minimization of panic-induced psychological penalty cost, psychological intervention cost, and costs associated with transportation and building shelters. The model is solved by aggregating objectives into a single objective by assigning weights to these objectives. With Wenchuan County as the test case, the epicenter of the 2008 Sichuan earthquake, the influence and the sensitivity of parameters, tradeoff among costs, and the effects of various functions of panic strength on psychological penalty and monetary costs are assessed using six experimental scenarios. Analytical results reveal the complexity and managerial insights gained by applying the proposed method to post-disaster evacuation and temporary resettlement.


id: cord-322123-z43vhxg5
author: Gardiner, Fergus W.
date: 2020-07-15
txt: ./txt/cord-322123-z43vhxg5.txt
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mime: text/plain
url: https://doi.org/10.1016/j.amj.2020.06.010
doi: 10.1016/j.amj.2020.06.010
summary:
  METHODS: All patients with a primary working diagnosis of International Statistical Classification of Diseases and Related Health Problems, 10th Version, Australian Modification F00 to F99 (mental and behavioral disorders) who underwent an air medical retrieval were included in this cost analysis. The primary aim of this article is to determine the annual air medical retrieval and in-patient hospital-direct medical costs associated with mental and behavioral disorders from a health payer perspective. 15, 16 Design and Participants A partial economic evaluation was undertaken using routinely collected air medical data for patients diagnosed in flight with a mental and behavioral disorder (International Statistical Classification of Diseases and Related Health Problems, 10th Edition, Australian Modification [ICD-10 AM], Chapter V) between January 1, 2017, and December 31, 2017. Further research is required to fully understand the true costs, including indirect (loss of productivity) and intangible costs (quality of life), associated with air medical retrievals for mental health care and the current level of service provision to rural and remote communities in location.

title:
  Mental Health Crises in Rural and Remote Australia: An Assessment of Direct Medical Costs of Air Medical Retrievals and the Implications for the Societal Burden

abstract:
  OBJECTIVE: Adequate mental health service provision in rural and remote Australian communities is problematic because of the tyranny of distance. The Royal Flying Doctor Service provides air medical retrieval for people in rural and remote areas. The economic impact on both the Royal Flying Doctor Service and the public hospital system for mental health–related air medical retrievals is unknown. We aimed to estimate the direct medical costs associated with air medical retrievals and subsequent hospitalizations for mental and behavioral disorders for the 2017 calendar year. METHODS: All patients with a primary working diagnosis of International Statistical Classification of Diseases and Related Health Problems, 10th Version, Australian Modification F00 to F99 (mental and behavioral disorders) who underwent an air medical retrieval were included in this cost analysis. International Statistical Classification of Diseases and Related Health Problems, 10th Edition, Australian Modification codes were mapped to Australian Refined Diagnosis Related Group codes, with hospital costs applied from the National Hospital Cost Data Collection (2016/2017). All costs are reported in 2017 Australian dollars (AUDs). RESULTS: One hundred twenty-two primary evacuations and 926 interhospital transfers occurred with an in-flight diagnosis of F00 to F99, most commonly psychotic disorders, including schizophrenia and schizotypal disorders. The total direct medical costs were estimated to be AUD $20,070,527. Costs for primary evacuations accounted for 13% (AUD $2,611,260), with the majority of this associated with the subsequent hospital admission (AUD $1,770,139). Similarly, the majority of the costs associated with interhospital transfers (total costs = AUD $17,459,267) were also related to hospital costs (AUD $13,569,187). CONCLUSION: Direct medical costs associated with air medical retrievals for people experiencing a mental health crisis are substantial. The majority of costs are associated with hospital admission and treatment; however, the indirect (loss of productivity) and intangible (quality of life) costs are likely to be far greater.


id: cord-345836-74d2mb70
author: Hogg, William
date: 2007-11-13
txt: ./txt/cord-345836-74d2mb70.txt
cache: ./cache/cord-345836-74d2mb70.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/17999757/
doi: 10.1186/1472-6963-7-181
summary:
  CONCLUSION: Based on our conservative estimates for the direct cost savings, there are indications that the outreach facilitation intervention program would be cost effective if it can achieve a reduction in the probability of infection on the order of 0.83 (0.77, 1.05) percentage points. The potential cost savings for this intervention referred to the costs of medical care averted due to the improved respiratory infection control practices that reduce the probability of infection in the physicians'' offices. In order to generate an accurate estimate of the total health-care costs averted by this intervention, one would require the following pieces of information: i) the incidence or frequencies of transmission at physicians'' office, ii) the effect of the intervention in reducing those rates, iii) the probabilities of the various potential health outcomes that could arise given infection, and iv) the cost of the treatments associated with those outcomes.

title:
  The costs of preventing the spread of respiratory infection in family physician offices: a threshold analysis

abstract:
  BACKGROUND: Influenza poses concerns about epidemic respiratory infection. Interventions designed to prevent the spread of respiratory infection within family physician (FP) offices could potentially have a significant positive influence on the health of Canadians. The main purpose of this paper is to estimate the explicit costs of such an intervention. METHODS: A cost analysis of a respiratory infection control was conducted. The costs were estimated from the perspective of provincial government. In addition, a threshold analysis was conducted to estimate a threshold value of the intervention's effectiveness that could generate potential savings in terms of averted health-care costs by the intervention that exceed the explicit costs. The informational requirements for these implicit costs savings are high, however. Some of these elements, such as the cost of hospitalization in the event of contacting influenza, and the number of patients passing through the physicians' office, were readily available. Other pertinent points of information, such as the proportion of infected people who require hospitalization, could be imported from the existing literature. We take an indirect approach to calculate a threshold value for the most uncertain piece of information, namely the reduction in the probability of the infection spreading as a direct result of the intervention, at which the intervention becomes worthwhile. RESULTS: The 5-week intervention costs amounted to a total of $52,810.71, or $131,094.73 prorated according to the length of the flu season, or $512,729.30 prorated for the entire calendar year. The variable costs that were incurred for this 5-week project amounted to approximately $923.16 per participating medical practice. The (fixed) training costs per practice were equivalent to $73.27 for the 5-week intervention, or $28.14 for 13-week flu season, or $7.05 for an entire one-year period. CONCLUSION: Based on our conservative estimates for the direct cost savings, there are indications that the outreach facilitation intervention program would be cost effective if it can achieve a reduction in the probability of infection on the order of 0.83 (0.77, 1.05) percentage points. A facilitation intervention initiative tailored to the environment and needs of the family medical practice and walk-in clinics is of promise for improving respiratory infection control in the physicians' offices.


id: cord-346984-36ryhc58
author: Kettani, Maryème
date: 2020-11-15
txt: ./txt/cord-346984-36ryhc58.txt
cache: ./cache/cord-346984-36ryhc58.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32863401/
doi: 10.1016/j.desal.2020.114627
summary:
  This paper examines the cost competitiveness of an extra-large-scale (275,000 m(3)/d) solar-powered desalination, taking as a case study the Chtouka Ait Baha plant in Morocco. This section briefly describes the Chtouka Ait Baha project, introduces the cost of water model (detailed in the Appendix A), gives an overview of the methodology used to calculate the cost of solar electricity and the cost of storage, and finally displays the four main scenarios of power supply retained in this paper. Indeed, as the paper mainly focused on the impact of different power supply options on the competitivity of a large scale desalination plant, the specific consumption of the SWRO (kWh/m 3 ) is first calculated, then the power required (kW) and finally the corresponding energy (kWh) over a given period (a year) are computed. When assessing the impact of the cost of electricity supply on the cost of desalinate water, this paper demonstrates that solar energy is a competitive way to feed large scale reverse osmosis plant today.

title:
  Techno-economic assessment of solar energy coupling with large-scale desalination plant: The case of Morocco

abstract:
  This paper examines the cost competitiveness of an extra-large-scale (275,000 m(3)/d) solar-powered desalination, taking as a case study the Chtouka Ait Baha plant in Morocco. It assesses the conditions at which solar Photovoltaics (PV) and Concentrated Solar Power (CSP) would be competitive with a grid (mainly fossil) driven desalination plant for the reference year and by 2030. The paper considers also a scenario where battery storage complements PV power generation. To conduct the analysis, a simple model of water cost calculation is built. Second, the cost related to energy consumption is calculated for different power supply options to evaluate the impact of energy provision cost on the final cost of water. The first main result of this paper is that desalinated water can be obtained at an acceptable cost of around 1 $/m(3). The second one is that PV without storage remains the cheapest power supply option today and by 2030. Storage based solution appears less competitive today but can be more attractive in a framework of increasing electricity grid prices and higher flexibility requirements in the future. The paper gives recommendations regarding the implication of different technology choices in the framework of the future Moroccan energy system.


id: cord-348992-8su58m68
title: Technoeconomic Modeling of Plant-Based Griffithsin Manufacturing
author: Alam, Aatif
date: 2018-07-24
txt: ./txt/cord-348992-8su58m68.txt
cache: ./cache/cord-348992-8su58m68.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/30087892/
doi: 10.3389/fbioe.2018.00102
summary:
  With an assumed commercial launch volume of 20 kg Griffithsin/year for 6.7 million doses of Griffithsin microbicide at 3 mg/dose, a transient vector expression yield of 0.52 g Griffithsin/kg leaf biomass, recovery efficiency of 70%, and purity of >99%, we calculated a manufacturing cost for the drug substance of $0.32/dose and estimated a bulk product cost of $0.38/dose assuming a 20% net fee for a contract manufacturing organization (CMO). The main analysis in this study was conducted using data available from pilot-scale manufacturing of Griffithsin in Nicotiana benthamiana plants using tobacco mosaic virus (TMV)-induced transient gene expression, and assuming that manufacturing would take place in an existing and fully equipped state-of-the-art plant-based biomanufacturing facility. Nicotiana benthamiana host plants are generated from seed and propagated indoors under controlled environmental conditions until sufficient biomass is obtained for inoculation with the TMV vector carrying the Griffithsin gene.

abstract:
  Griffithsin is a marine algal lectin that exhibits broad-spectrum antiviral activity by binding oligomannose glycans on viral envelope glycoproteins, including those found in HIV-1, HSV-2, SARS, HCV and other enveloped viruses. An efficient, scalable and cost-effective manufacturing process for Griffithsin is essential for the adoption of this drug in human antiviral prophylaxis and therapy, particularly in cost-sensitive indications such as topical microbicides for HIV-1 prevention. The production of certain classes of recombinant biologics in plants can offer scalability, cost and environmental impact advantages over traditional biomanufacturing platforms. Previously, we showed the technical viability of producing recombinant Griffithsin in plants. In this study, we conducted a technoeconomic analysis (TEA) of plant-produced Griffithsin manufactured at commercial launch volumes for use in HIV microbicides. Data derived from multiple non-sequential manufacturing batches conducted at pilot scale and existing facility designs were used to build a technoeconomic model using SuperPro Designer(®) modeling software. With an assumed commercial launch volume of 20 kg Griffithsin/year for 6.7 million doses of Griffithsin microbicide at 3 mg/dose, a transient vector expression yield of 0.52 g Griffithsin/kg leaf biomass, recovery efficiency of 70%, and purity of >99%, we calculated a manufacturing cost for the drug substance of $0.32/dose and estimated a bulk product cost of $0.38/dose assuming a 20% net fee for a contract manufacturing organization (CMO). This is the first report modeling the manufacturing economics of Griffithsin. The process analyzed is readily scalable and subject to efficiency improvements and could provide the needed market volumes of the lectin within an acceptable range of costs, even for cost-constrained products such as microbicides. The manufacturing process was also assessed for environmental, health and safety impact and found to have a highly favorable environmental output index with negligible risks to health and safety. The results of this study help validate the plant-based manufacturing platform and should assist in selecting preferred indications for Griffithsin as a novel drug.


id: cord-353726-e0mr8kqb
title: Strategies for managing risk in a changing aviation environment
author: Adler, Nicole
date: 2012-07-31
txt: ./txt/cord-353726-e0mr8kqb.txt
cache: ./cache/cord-353726-e0mr8kqb.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0969699711001360
doi: 10.1016/j.jairtraman.2011.12.014
summary:
  Abstract Given the increasing volatility in the economic performance of airlines, partially reflecting the dynamics of demand for air transport and the fixed costs associated with the industry, all stakeholders need to consider appropriate strategies for better managing the risks. These strategies need to provide a cushion whereby companies can reasonably handle the risk of fuel price instability, the introduction of carbon cap and trade regulation, the need to finance airport infrastructure, air traffic management systems, aircraft and other assets, the competitive inequalities drawing from subsidies across the globe at various levels of the supply chain and the effects of increasing ad-hoc consumer protection laws. We discuss the on-going process of deregulation of the airline markets in section 5.1, the conditions under which airport regulation continues to be a necessity in a gradually privatized and corporatized airport industry in section 5.2 and the issues arising as a result of the changes in ownership form of the air traffic control sector in section 5.3.

abstract:
  Abstract Given the increasing volatility in the economic performance of airlines, partially reflecting the dynamics of demand for air transport and the fixed costs associated with the industry, all stakeholders need to consider appropriate strategies for better managing the risks. Many risks were identified in the literature previously, some even decades ago, however most have yet to be satisfactorily addressed. Urgency is growing. Removal of the remaining barriers to competition at all levels, congestion management, open skies policies across continents, computer-centric air traffic management systems and increased research and development into the processes and technology needed to reduce environmental externalities remain among the top challenges for the next decade.


