Measuring trade-offs that matter: assessing the impact of a new electronic cross-match policy on the turnaround time and the cross-match workload efficiency

Transfusion ◽  
2014 ◽  
Vol 54 (12) ◽  
pp. 3075-3079 ◽  
Author(s):  
David M. Lin ◽  
Dennis Goldfinger ◽  
Qun Lu ◽  
Bridget Wallace ◽  
Dawn Kosaka-Nguyen ◽  
...  
Keyword(s):  
Turnaround Time ◽  
Trade Offs ◽  
The Cross ◽  
The Impact ◽  
Cross Match

scholarly journals Carbon Dynamics in the Northeastern Qinghai–Tibetan Plateau from 1990 to 2030 Using Landsat Land Use/Cover Change Data

2020 ◽  
Vol 12 (3) ◽  
pp. 528 ◽  
Author(s):  
Jingye Li ◽  
Jian Gong ◽  
Jean-Michel Guldmann ◽  
Shicheng Li ◽  
Jie Zhu
Keyword(s):  
Land Use ◽  
Tibetan Plateau ◽  
Carbon Storage ◽  
Sharp Decrease ◽  
Total Carbon ◽  
Qinghai Lake ◽  
Lake Basin ◽  
Ecosystem Carbon ◽  
Trade Offs ◽  
The Impact

Land use/cover change (LUCC) has an important impact on the terrestrial carbon cycle. The spatial distribution of regional carbon reserves can provide the scientific basis for the management of ecosystem carbon storage and the formulation of ecological and environmental policies. This paper proposes a method combining the CA-based FLUS model and the Integrated Valuation of Ecosystem Services and Trade-offs (InVEST) model to assess the temporal and spatial changes in ecosystem carbon storage due to land-use changes over 1990–2015 in the Qinghai Lake Basin (QLB). Furthermore, future ecosystem carbon storage is simulated and evaluated over 2020–2030 under three scenarios of natural growth (NG), cropland protection (CP), and ecological protection (EP). The long-term spatial variations in carbon storage in the QLB are discussed. The results show that: (1) Carbon storage in the QLB decreased at first (1990–2000) and increased later (2000–2010), with total carbon storage increasing by 1.60 Tg C (Teragram: a unit of mass equal to 1012 g). From 2010 to 2015, carbon storage displayed a downward trend, with a sharp decrease in wetlands and croplands as the main cause; (2) Under the NG scenario, carbon reserves decrease by 0.69 Tg C over 2020–2030. These reserves increase significantly by 6.77 Tg C and 7.54 Tg C under the CP and EP scenarios, respectively, thus promoting the benign development of the regional ecological environment. This study improves our understanding on the impact of land-use change on carbon storage for the QLB in the northeastern Qinghai–Tibetan Plateau (QTP).

scholarly journals Investigation of the functional network modifier loading on the stoichiometric ratio of epoxy resins and their dielectric properties

2021 ◽  
Author(s):  
Istebreq A. Saeedi ◽  
Sunny Chaudhary ◽  
Thomas Andritsch ◽  
Alun S. Vaughan
Keyword(s):  
Glass Transition ◽  
Dielectric Properties ◽  
Electrical Properties ◽  
Epoxy Resins ◽  
Functional Network ◽  
Cross Linking ◽  
Network Modifier ◽  
Epoxy Resin System ◽  
The Cross ◽  
The Impact

AbstractReactive molecular additives have often been employed to tailor the mechanical properties of epoxy resins. In addition, several studies have reported improved electrical properties in such systems, where the network architecture and included function groups have been modified through the use of so-called functional network modifier (FNM) molecules. The study reported here set out to investigate the effect of a glycidyl polyhedral oligomeric silsesquioxane (GPOSS) FNM on the cross-linking reactions, glass transition, breakdown strength and dielectric properties of an amine-cured epoxy resin system. Since many previous studies have considered POSS to act as an inorganic filler, a key aim was to consider the impact of GPOSS addition on the stoichiometry of curing. Fourier transform infrared spectroscopy revealed significant changes in the cross-linking reactions that occur if appropriate stoichiometric compensation is not made for the additional epoxide groups present on the GPOSS. These changes, in concert with the direct effect of the GPOSS itself, influence the glass transition temperature, dielectric breakdown behaviour and dielectric response of the system. Specifically, the work shows that the inclusion of GPOSS can result in beneficial changes in electrical properties, but that these gains are easily lost if consequential changes in the matrix polymer are not appropriately counteracted. Nevertheless, if the system is appropriately optimized, materials with pronounced improvements in technologically important characteristics can be designed.

scholarly journals Discrete choice experiment for eliciting preference for health services for patients with ALS and their informal caregivers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Katy Tobin ◽  
Sinead Maguire ◽  
Bernie Corr ◽  
Charles Normand ◽  
Orla Hardiman ◽  
...  
Keyword(s):  
Health Services ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Strong Preference ◽  
Multidisciplinary Teams ◽  
Relative Importance ◽  
Trade Offs ◽  
Als Patients ◽  
The Impact

Abstract Background Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative condition with a mean life expectancy of 3 years from first symptom. Understanding the factors that are important to both patients and their caregivers has the potential to enhance service delivery and engagement, and improve efficiency. The Discrete Choice Experiment (DCE) is a stated preferences method which asks service users to make trade-offs for various attributes of health services. This method is used to quantify preferences and shows the relative importance of the attributes in the experiment, to the service user. Methods A DCE with nine choice sets was developed to measure the preferences for health services of ALS patients and their caregivers and the relative importance of various aspects of care, such as timing of care, availability of services, and decision making. The DCE was presented to patients with ALS, and their caregivers, recruited from a national multidisciplinary clinic. A random effects probit model was applied to estimate the impact of each attribute on a participant’s choice. Results Patients demonstrated the strongest preferences about timing of receiving information about ALS. A strong preference was also placed on seeing the hospice care team later rather than early on in the illness. Patients also indicated their willingness to consider the use of communication devices. Grouping by stage of disease, patients who were in earlier stages of disease showed a strong preference for receipt of extensive information about ALS at the time of diagnosis. Caregivers showed a strong preference for engagement with healthcare professionals, an attribute that was not prioritised by patients. Conclusions The DCE method can be useful in uncovering priorities of patients and caregivers with ALS. Patients and caregivers have different priorities relating to health services and the provision of care in ALS, and patient preferences differ based on the stage and duration of their illness. Multidisciplinary teams must calibrate the delivery of care in the context of the differing expectations, needs and priorities of the patient/caregiver dyad.

scholarly journals Modeling Energy Communities with Collective Photovoltaic Self-Consumption: Synergies between a Small City and a Winery in Portugal

Energies ◽  
2021 ◽  
Vol 14 (2) ◽  
pp. 323
Author(s):  
Guilherme Pontes Luz ◽  
Rodrigo Amaro e Silva
Keyword(s):  
Economic Feasibility ◽  
Small City ◽  
Total System ◽  
Trade Offs ◽  
Southern Portugal ◽  
Energy Community ◽  
Individual Self ◽  
The Impact ◽  
The City ◽  
Modest Reduction

The recently approved regulation on Energy Communities in Europe is paving the way for new collective forms of energy consumption and production, mainly based on photovoltaics. However, energy modeling approaches that can adequately evaluate the impact of these new regulations on energy community configurations are still lacking, particularly with regards to the grid tariffs imposed on collective systems. Thus, the present work models three different energy community configurations sustained on collective photovoltaics self-consumption for a small city in southern Portugal. This energy community, which integrates the city consumers and a local winery, was modeled using the Python-based Calliope framework. Using real electricity demand data from power transformers and an actual winery, the techno-economic feasibility of each configuration was assessed. Results show that all collective arrangements can promote a higher penetration of photovoltaic capacity (up to 23%) and a modest reduction in the overall cost of electricity (up to 8%). However, there are clear trade-offs between the different pathways: more centralized configurations have 53% lower installation costs but are more sensitive to grid use costs (which can represent up to 74% of the total system costs). Moreover, key actor’s individual self-consumption rate may decrease by 10% in order to benefit the energy community as a whole.

scholarly journals Impact of Rapid PCR Influenza Testing on the Rate of Inpatient Admissions During Influenza Season at a Tertiary-Care Center

2020 ◽  
Vol 41 (S1) ◽  
pp. s263-s264
Author(s):  
Jordan Polistico ◽  
Avnish Sandhu ◽  
Teena Chopra ◽  
Erin Goldman ◽  
Jennifer LeRose ◽  
...  
Keyword(s):  
Influenza Season ◽  
Care Center ◽  
Tertiary Care ◽  
The United States ◽  
Turnaround Time ◽  
Care Hospital ◽  
Tertiary Care Center ◽  
Pediatric Hospital ◽  
Rapid Pcr ◽  
The Impact

Background: Influenza causes a high burden of disease in the United States, with an estimate of 960,000 hospitalizations in the 2017–2018 flu season. Traditional flu diagnostic polymerase chain reaction (PCR) tests have a longer (24 hours or more) turnaround time that may lead to an increase in unnecessary inpatient admissions during peak influenza season. A new point-of-care rapid PCR assays, Xpert Flu, is an FDA-approved PCR test that has a significant decrease in turnaround time (2 hours). The present study sought to understand the impact of implementing a new Xpert Flu test on the rate of inpatient admissions. Methods: A retrospective study was conducted to compare rates of inpatient admissions in patients tested with traditional flu PCR during the 2017–2018 flu season and the rapid flu PCR during the 2018–2019 flu season in a tertiary-care center in greater Detroit area. The center has 1 pediatric hospital (hospital A) and 3 adult hospitals (hospital B, C, D). Patients with influenza-like illness who presented to all 4 hospitals during 2 consecutive influenza seasons were analyzed. Results: In total, 20,923 patients were tested with either the rapid flu PCR or the traditional flu PCR. Among these, 14,124 patients (67.2%) were discharged from the emergency department and 6,844 (32.7%) were admitted. There was a significant decrease in inpatient admissions in the traditional flu PCR group compared to the rapid flu PCR group across all hospitals (49.56% vs 26.6% respectively; P < .001). As expected, a significant proportion of influenza testing was performed in the pediatric hospital, 10,513 (50.2%). A greater reduction (30% decrease in the rapid flu PCR group compared to the traditional flu PCR group) was observed in inpatient admissions in the pediatric hospital (Table 1) Conclusions: Rapid molecular influenza testing can significantly decrease inpatient admissions in a busy tertiary-care hospital, which can indirectly lead to improved patient quality with easy bed availability and less time spent in a private room with droplet precautions. Last but not the least, this testing method can certainly lead to lower healthcare costs.Funding: NoneDisclosures: None

Are neutrophil extracellular traps the link for the cross-talk between periodontitis and rheumatoid arthritis physiopathology?

Rheumatology ◽  
2021 ◽  
Author(s):  
Sicília Rezende Oliveira ◽  
José Alcides A de Arruda ◽  
Ayda Henriques Schneider ◽  
Valessa Florindo Carvalho ◽  
Caio Machado ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cross Talk ◽  
Neutrophil Extracellular Traps ◽  
Periodontal Therapy ◽  
Clinical Parameters ◽  
Extracellular Traps ◽  
Early Ra ◽  
The Cross ◽  
High Concentrations ◽  
The Impact

Abstract Objectives Neutrophil extracellular traps (NETs) play a role in the pathogenesis of periodontitis and rheumatoid arthritis (RA). However, it remains poorly understood whether NETs participate in the cross-talk between periodontitis and RA. Herein, we investigated the production of NETs in individuals with periodontitis and RA and its association with clinical parameters. The impact of periodontal therapy on RA and NET release was also assessed. Methods The concentration of NETs and cytokines was determined in the saliva and plasma of individuals with early RA (n = 24), established RA (n = 64), and individuals without RA (n = 76). The influence of periodontitis on the production of NETs and cytokines was also evaluated. Results Individuals with early RA had a higher concentration of NETs in saliva and plasma than individuals with established RA or without RA. Periodontitis resulted in an increase in the concentration of NETs of groups of individuals without RA and with early RA. The proportion of individuals with high concentrations of IL-6, IL-10 and GM-CSF was higher among individuals with periodontitis than among individuals without periodontitis. The concentrations of TNF-α, IL-6, IL-17/IL-25, and IL-28A were particularly high in individuals with early RA. Worse periodontal clinical parameters, RA onset and RA activity were significantly associated with circulating NETs. Periodontal therapy was associated with a reduction in the concentration of NETs and inflammatory cytokines and amelioration in periodontitis and RA. Conclusion This study reveals that NETs are a possible link between periodontitis and RA, with periodontal therapy resulting in a dramatic switch in circulating NET levels.

Why Do Firms Participate in Voluntary Environmental Programs? A Meta-Analysis of the Role of Institutions, Resources, and Program Stringency

2021 ◽  
pp. 108602662199006
Author(s):  
Peter Tashman ◽  
Svetlana Flankova ◽  
Marc van Essen ◽  
Valentina Marano
Keyword(s):  
Quality Management ◽  
Prior Experience ◽  
Meta Analysis ◽  
Institutional Pressures ◽  
Environmental Programs ◽  
Voluntary Environmental Programs ◽  
Management Standards ◽  
Trade Offs ◽  
The Impact

We meta-analyze research on why firms join voluntary environmental programs (VEPs) to assess the impact of program stringency, or the extent to which they have rigorous, enforceable standards on these decisions. Stringency creates trade-offs for firms by affecting programs’ effectiveness, legitimacy, and adoption costs. Most research considers singular programs and lacks cross program variation needed to analyze program stringency’s impact. Our meta-analysis addresses this by sampling 127 studies and 23 VEPs. We begin by identifying common institutional and resource-based drivers of participation in the literature, and then analyze how program stringency moderates their impacts. Our results suggest that strictly governed VEPs encourage participation among highly visible and profitable firms, and discourage it when informal institutional pressures are higher, and firms have prior experience with other VEPs or quality management standards. We demonstrate that VEP stringency has nuanced effects on firm participation based on the institutional and resource-based factors facing them.

scholarly journals Optimising pasture and grazing management decisions on the Cicerone Project farmlets over variable time horizons

2013 ◽  
Vol 53 (8) ◽  
pp. 796 ◽  
Author(s):  
Karl Behrendt ◽  
Oscar Cacho ◽  
James M. Scott ◽  
Randall Jones
Keyword(s):  
Simulation Model ◽  
Strategic Decision ◽  
Stochastic Dynamic ◽  
Economic Returns ◽  
Strategic Decisions ◽  
Trade Offs ◽  
Using Data ◽  
Time Frames ◽  
The Impact ◽  
Stocking Rates

This study addresses the problem of balancing the trade-offs between the need for animal production, profit, and the goal of achieving persistence of desirable species within grazing systems. The bioeconomic framework applied in this study takes into account the impact of climate risk and the management of pastures and grazing rules on the botanical composition of the pasture resource, a factor that impacts on livestock production and economic returns over time. The framework establishes the links between inputs, the state of the pasture resource and outputs, to identify optimal pasture development strategies. The analysis is based on the application of a dynamic pasture resource development simulation model within a seasonal stochastic dynamic programming framework. This enables the derivation of optimum decisions within complex grazing enterprises, over both short-term tactical (such as grazing rest) and long-term strategic (such as pasture renovation) time frames and under climatic uncertainty. The simulation model is parameterised using data and systems from the Cicerone Project farmlet experiment. Results indicate that the strategic decision of pasture renovation should only be considered when pastures are in a severely degraded state, whereas the tactical use of grazing rest or low stocking rates should be considered as the most profitable means of maintaining adequate proportions of desirable species within a pasture sward. The optimal stocking rates identified reflected a pattern which may best be described as a seasonal saving and consumption cycle. The optimal tactical and strategic decisions at different pasture states, based on biomass and species composition, varies both between seasons and in response to the imposed soil fertility regime. Implications of these findings at the whole-farm level are discussed in the context of the Cicerone Project farmlets.

Capturing Effects of Maintenance Practices in Highway Asset Valuation: Replacement-Cost Approach Versus Book-Value Method

2003 ◽  
Vol 1824 (1) ◽  
pp. 57-65 ◽  
Author(s):  
Poovadol Sirirangsi ◽  
Adjo Amekudzi ◽  
Pannapa Herabat
Keyword(s):  
Pavement Management ◽  
Added Value ◽  
Replacement Cost ◽  
Asset Valuation ◽  
Book Value ◽  
Cost Approach ◽  
Trade Offs ◽  
Study Results ◽  
Asset Value ◽  
The Impact

The replacement-cost approach and the book-value method as decision support tools for selecting maintenance alternatives under budget constraints and for capturing the effects of maintenance practices on highway asset value are investigated. By using a case study based on the Thailand Pavement Management System, the replacement-cost approach and the book-value method are applied to analyze maintenance alternatives for selected highways. The versatility of these asset-valuation methods is explored for capturing trade-offs in the type and timing of maintenance and for incorporating the added value of effective maintenance practices and the impact of deferred maintenance in the overall asset value. The study demonstrated that the replacement-cost approach is a more versatile tool for considering the maintenance-related value of highways in maintenance decision making, whereas the book value may be a simpler financial accounting tool. The two approaches may be used together to clarify how maintenance expenditures are being translated into facility replacement value or how the overall value of the infrastructure is being preserved. The study results are potentially useful to agencies interested in capturing the added value of effective maintenance practices in the overall value of their asset base.

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