scholarly journals AI-Based Physical and Virtual Platform with 5-Layered Architecture for Sustainable Smart Energy City Development

2019 ◽  
Vol 11 (16) ◽  
pp. 4479 ◽  
Author(s):  
Sanguk Park ◽  
Sanghoon Lee ◽  
Sangmin Park ◽  
Sehyun Park
Keyword(s):  
Return On Investment ◽  
Cost Savings ◽  
Economic Benefits ◽  
Urban Environments ◽  
Sustainable Cities ◽  
City Development ◽  
Layered Architecture ◽  
Before And After ◽  
Virtual Platform ◽  
Energy Element

To build sustainable smart energy cities (SECs) around the world, many countries are now combining customized services and businesses within their energy infrastructure and urban environments. Such changes could then promote the development of platforms that ultimately provide benefits for citizens such as convenience, safety, and cost savings. Currently, the development of technologies for SECs focuses on independent products and unit technology. However, this is problematic, as it may not be possible to develop sustainable cities if there is a lack of connectivity between various elements within the SEC. To solve such problems, this paper presents an AI-based physical and virtual platform using a 5-layer architecture to develop a sustainable smart energy city (SSEC). The architecture employs both a top-down and bottom-up approach and the links between each energy element in the SSEC can readily be analyzed. The economic analysis based on return on investment (ROI) is carried out by comparing the economic benefits before and after the application of this system. Deploying the proposed platform will enable the speedy development and application of new services for SSECs and will provide SSECs with measures to ensure sustainable development, such as rapid urban development, and cost reductions.

In Search of Indicators for Assessing Smart and Sustainable Cities and Communities' Performance

2017 ◽  
Vol 6 (1) ◽  
pp. 43-73 ◽  
Author(s):  
Anastasia Stratigea ◽  
Akrivi Leka ◽  
Maria Panagiotopoulou
Keyword(s):  
Selection Process ◽  
Smart Cities ◽  
Indicator System ◽  
Urban Environments ◽  
Sustainability Indicators ◽  
Sustainable Cities ◽  
City Development ◽  
Sustainable City ◽  
Policy Makers ◽  
Support Policy

The goal of the paper is to elaborate on sustainability aspects of smart sustainable urban environments. More specifically, at a first step the paper aims at critically reviewing globally initiated state-of-the-art approaches for assessing smart cities' performance as to sustainability objectives. The scope of this effort is to identify sets of indicators used in different approaches as well as convergence/divergence among them. Secondly, an attempt to integrate different indicator sets into a more enriched and coherent indicator system is carried out which, by effectively embedding smart and sustainable city development into sustainability indicators' sets, can be used by various types of cities' examples. Finally, the rationale of the indicators' selection process is depicted, in order to support policy makers and planners' guidance towards choosing an appropriate, city-specific set of sustainability indicators for carrying out relevant assessments.

scholarly journals Improving Aztreonam Stewardship and Cost Through a Penicillin Allergy Testing Clinical Guideline

2018 ◽  
Vol 5 (6) ◽  
Author(s):  
Justin R Chen ◽  
Scott A Tarver ◽  
Kristin S Alvarez ◽  
Wenjing Wei ◽  
David A Khan
Keyword(s):  
Skin Testing ◽  
Cost Savings ◽  
Cost Effective ◽  
Clinical Decision ◽  
Economic Benefits ◽  
Penicillin Allergy ◽  
Negative Consequences ◽  
Allergy Testing ◽  
Stewardship Program ◽  
Before And After

Abstract Background Patients reporting penicillin allergy often receive unnecessary and costly broad-spectrum alternatives such as aztreonam with negative consequences. Penicillin allergy testing improves antimicrobial therapy but is not broadly used in hospitals due to insufficient testing resources and short-term expenses. We describe a clinical decision support (CDS) tool promoting pharmacist-administered penicillin allergy testing in patients receiving aztreonam and its benefits toward antimicrobial stewardship and costs. Methods A CDS tool was incorporated into the electronic medical record, directing providers to order penicillin allergy testing for patients receiving aztreonam. An allergy-trained pharmacist reviewed orders placed through this new guideline and performed skin testing and oral challenges to determine whether these patients could safely take penicillin. Data on tests performed, antibiotic utilization, and cost-savings were compared with patients tested outside the new guideline as part of our institution’s standard stewardship program. Results The guideline significantly increased penicillin allergy testing among patients receiving aztreonam from 24% to 85% (P < .001) while reducing the median delay between admission and testing completion from 3.31 to 1.05 days (P = 0.008). Patients tested under the guideline saw a 58% increase in penicillin exposure (P = .046). Institutional aztreonam administration declined from 2.54 to 1.47 administrations per 1000 patient-days (P = .016). Average antibiotic costs per patient tested before and after CDS decreased from $1265.81 to $592.08 USD, a 53% savings. Conclusions Targeting penicillin allergy testing to patients on aztreonam yields therapeutic and economic benefits during a single admission. This provides a cost-effective model for inpatient testing.

scholarly journals 1787. The Effects of a Systemwide Diagnostic Stewardship Change on West Nile Virus Disease Ordering Practices

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S658-S658
Author(s):  
Andrew H Karaba ◽  
Paul W Blair ◽  
Kevin M Martin ◽  
Mustapha O Saheed ◽  
Karen C Carroll ◽  
...  
Keyword(s):  
West Nile Virus ◽  
Virus Disease ◽  
Case Fatality ◽  
Cost Savings ◽  
Primary Objective ◽  
Neurological Deficits ◽  
West Nile ◽  
Hospital System ◽  
Elisa Testing ◽  
Before And After

Abstract Background Neuroinvasive West Nile Virus (WNV) often leads to prolonged neurological deficits and carries a high case fatality rate. The CSF IgM (MAC-ELISA) is preferred over the CSF nucleic acid-based test (NAAT) by the CDC due to its higher sensitivity. However, our hospital system was observed to have an over-utilization of NAAT testing compared with MAC-ELISA testing. The primary objective was to compare the number of MAC-ELISA and NAAT WNV tests ordered before and after a diagnostic stewardship intervention. The secondary objectives were to determine whether this change to lead to any cost savings and increased detection of probable cases of WNV-ND. Methods In an effort to increase the use of the MAC-ELISA and to decrease unnecessary NAAT testing, the NAAT test was removed in April 2018 from the test menu in the electronic health record of a health system comprising five hospitals in the Maryland and Washington, D.C. area. NAAT testing remained possible via a paper order form. This study was a retrospective review of WNV testing done on CSF samples from July 2016 through December 2018. The seasonal and yearly number of total tests, positive tests, and total costs were determined from the period of July, 2017 to April, 2018 and were compared with May, 2018 to January, 2019. A paired t-test was performed to evaluate for differences in total testing, total positives, and total costs during non-winter months before and after the intervention. Results A total of 12.59 MAC-ELISA tests/month (95% CI: 10.29, 14.89) increased to 41 tests/month (95% CI: 34.35, 47.65) which was significantly different (P < 0.001). In contrast, there were 46.23 NAAT tests/month (95% CI: 39.55, 52.91) which decreased to 0 NAAT tests/month after the intervention (P < 0.001). This resulted in an average decrease in WNV test spending from $7200 per month to $471 per month (P < 0.001). Preceding the intervention in test ordering, 0.23% of WNV CSF tests were positive (NAAT+MAC-ELISA) while 2.44% WNV CSF tests were positive after the intervention (P = 0.03). Conclusion Elimination of electronic WNV NAAT ordering is an effective way of decreasing inappropriate WNV NAAT testing, decreasing associated costs, and may lead to improved diagnosis of WNV-ND. Disclosures All authors: No reported disclosures.

scholarly journals Joint Consultation Clinic by Infectious Diseases Specialists and Podiatry team (ID-POD) Compliments the Care of Diabetic Patients with Foot Infections by Reducing Cost and Decreasing Outpatient Clinic Visits

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S328-S328
Author(s):  
Pushpalatha Bangalore Lingegowda ◽  
Say-Tat Ooi ◽  
Jyoti Somani ◽  
Chelsea Law ◽  
Boon Kiak Yeo
Keyword(s):  
Infectious Diseases ◽  
Diabetic Foot ◽  
Wound Care ◽  
Cost Savings ◽  
Outpatient Setting ◽  
Multidisciplinary Teams ◽  
Diabetic Patients ◽  
Wound Debridement ◽  
Diabetic Foot Infections ◽  
Before And After

Abstract Background Management of diabetic foot infections (DFI) is challenging and involves multidisciplinary teams to improve outcomes (1). Appropriate wound care of patients with DFI plays an important role in successfully curing infections and promote wound healing. In Singapore, Infectious Diseases (ID) specialists help in the management of DFI by recommending appropriate antibiotics for infected wounds while wound debridement are managed by Podiatrists (POD). When patients are hospitalized multidisciplinary teams including Vascular Surgery review patients. In the outpatient setting patients have multiple appointments including ID and Endocrinology etc. The time spent and costs incurred by patients for traveling to multiple appointments is considerable. A joint ID-POD clinic was initiated to reduce the cost and inconvenience for patients. Methods A joint weekly clinic was initiated in October’16 and the data was analyzed upto May’17. Finance was involved in deriving costs. The service costs for consultations payable by patients before and after the initiation of the joint clinic were compared. Results First 6 months experience of initiating the joint ID-POD clinic is reported. 35 unique patients had a total of 88 visits. 1/third of the patients had more than 2 visits to the joint clinic. For each visit to the joint clinic the patient paid 25% less compared with having separate clinics. The hospital lowered the service cost for the new clinic by 11%. This was done by minimizing the time involvement of the ID physician. Conclusion Joint ID-POD clinic for managing diabetic patients with foot infections revealed several advantages. Hospital outpatient visits for each patient decreased by 50% for those requiring care of both ID and POD, without compromising care. With the consolidation of care each individual patient had a cost savings of 25% for the joint consultation. This joint clinic while making it convenient for patients has revealed significant cost savings to patients especially for those requiring multiple visits. We recommend hospitals with high prevalence of Diabetes and Diabetic foot infections to consider joint ID-POD clinics to reduce hassle and increase saving for patients. Disclosures All authors: No reported disclosures.

scholarly journals Malaria elimination transmission and costing in the Asia-Pacific: Developing an investment case

2020 ◽  
Vol 4 ◽  
pp. 60 ◽  
Author(s):  
Rima Shretta ◽  
Sheetal Prakash Silal ◽  
Olivier J. Celhay ◽  
Chris Erwin Gran Mercado ◽  
Shwe Sin Kyaw ◽  
...  
Keyword(s):  
Health System ◽  
Malaria Elimination ◽  
Return On Investment ◽  
Premature Death ◽  
Economic Benefits ◽  
Asia Pacific ◽  
Transmission Model ◽  
Mortality And Morbidity ◽  
Lost Productivity ◽  
Coverage Rates

Background: The Asia-Pacific region has made significant progress against malaria, reducing cases and deaths by over 50% between 2010 and 2015. These gains have been facilitated in part, by strong political and financial commitment of governments and donors. However, funding gaps and persistent health system challenges threaten further progress. Achieving the regional goal of malaria elimination by 2030 will require an intensification of efforts and a plan for sustainable financing. This article presents an investment case for malaria elimination to facilitate these efforts. Methods: A transmission model was developed to project rates of decline of Plasmodium falciparum and Plasmodium vivax malaria and the output was used to determine the cost of the interventions that would be needed for elimination by 2030. In total, 80 scenarios were modelled under various assumptions of resistance and intervention coverage. The mortality and morbidity averted were estimated and health benefits were monetized by calculating the averted cost to the health system, individual households, and society. The full-income approach was used to estimate the economic impact of lost productivity due to premature death and illness, and a return on investment was computed. Results: The study estimated that malaria elimination in the region by 2030 could be achieved at a cost of USD 29.02 billion (range: USD 23.65-36.23 billion) between 2017 and 2030. Elimination would save over 400,000 lives and avert 123 million malaria cases, translating to almost USD 90 billion in economic benefits. Discontinuing vector control interventions and reducing treatment coverage rates to 50% will result in an additional 845 million cases, 3.5 million deaths, and excess costs of USD 7 billion. Malaria elimination provides a 6:1 return on investment. Conclusion: This investment case provides compelling evidence for the benefits of continued prioritization of funding for malaria and can be used to develop an advocacy strategy.

scholarly journals Economic assessment of urban space and blue-green infrastructure in Singapore

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mabel Lim ◽  
Stefanos Xenarios
Keyword(s):  
Urban Space ◽  
Green Infrastructure ◽  
Life Quality ◽  
Economic Assessment ◽  
Well Being ◽  
Pilot Project ◽  
Economic Benefits ◽  
Mean Value ◽  
Urban Environments ◽  
Urban Greenery

Abstract The urban conglomeration has accentuated the role of urban greenery as a determinant factor for sustainable living, especially in highly dense cities. The country of Singapore has consistently attempted to develop and rehabilitate urban greenery by attempting to align the green space policy with the pursuit of better life quality. In this study, we assess the benefits arising from the rehabilitated Bishan-Ang Mo Kio (AMK) Park in north Singapore and the effects on economic welfare. The Bishan-AMK Park was initially constructed in the late 70 s as a drainage area for the avoidance of flooding incidents. In 2012, a pilot project was introduced to create a blue-green infrastructure (BGI) space for the provision of drainage and flood prevention but also for recreational and environmental improvement in the area. Yet, the benefits emerging from BGI are not well explored and still underestimated. To this extent, we evaluate selected services related to recreational, socio-cultural and tourism-related values by indicating the economic benefits from the introduction of BGI in condensed urban environments like Singapore. The findings indicate that the benefits deriving from the selected services could be within the range of US$100 million to US$220 million with a mean value of US$160 million per year by substantially contributing to human well-being. The assessment of environmental services can raise the awareness of residents and local authorities on the contribution of urban greenery to livelihoods and economic development in Singapore and similar densely populated areas.

Assessment of Cost-Effective Antibiotic Therapy in the Management of Infections in Cancer Patients

1994 ◽  
Vol 28 (1) ◽  
pp. 105-111 ◽  
Author(s):  
Michael A. Cimino ◽  
Coleman M. Rotstein ◽  
Jason E. Moser
Keyword(s):  
Quality Improvement ◽  
Antibiotic Therapy ◽  
Clinical Pharmacist ◽  
Hospital Setting ◽  
Cost Savings ◽  
Cost Effective ◽  
Baseline Period ◽  
Economic Benefits ◽  
Consensus Approach ◽  
Quality Improvement Effort

OBJECTIVE: To describe the economic benefits of a quality improvement effort directed at optimizing clinical outcome. DESIGN: A before—after observational design was used to evaluate the cost-effectiveness of a consensus approach to antimicrobial therapy. SETTING: The evaluation was conducted at a cancer research hospital. PATIENTS: Oncology patients requiring parenteral antibiotic therapy were consecutively observed. MAIN OUTCOME MEASURES: Outcome (clinical and microbiologic response), safety, and cost of therapy were assessed during a baseline period and compared to a period during which the consensus approach was used. INTERVENTIONS: The influence of a designated individual, in this case a clinical pharmacist, responsible for promotion of the consensus approach was explored. RESULTS: The consensus approach in combination with the promotional efforts of the clinical pharmacist was associated with a 13 percent increase in overall clinical response and a reduction of pathogen persistence from 22 to 11 percent. No difference in the average number of adverse effects per patient was observed over the two observation periods. These findings were associated with an estimated $22000/month cost savings. The consensus approach alone, without benefit of the clinical pharmacist, was not associated with improved therapeutic outcome or cost savings over the same observation periods. CONCLUSIONS: These data suggest that a consensus approach to antibiotic therapy can be cost-effective. An individual, such as a clinical pharmacist, may add significantly to quality improvement and cost-effective efforts in a hospital setting.

Return on investment of Canadian tobacco control policies implemented between 2001 and 2016

2021 ◽  
pp. tobaccocontrol-2021-056473
Author(s):  
Jean-Eric Tarride ◽  
Gord Blackhouse ◽  
G. Emmanuel Guindon ◽  
Michael O Chaiton ◽  
Lynn Planinac ◽  
...  
Keyword(s):  
Tobacco Control ◽  
Return On Investment ◽  
Economic Benefits ◽  
Sensitivity Analyses ◽  
Control Policies ◽  
Productivity Costs ◽  
Tobacco Policies ◽  
Tobacco Control Policies ◽  
Life Years ◽  
The Government

ObjectivesTo determine the return on investment (ROI) associated with tobacco control policies implemented between 2001 and 2016 in Canada.MethodsCanadian expenditures on tobacco policies were collected from government sources. The economic benefits considered in our analyses (decrease in healthcare costs, productivity costs and monetised life years lost, as well as tax revenues) were based on the changes in smoking prevalence and attributable deaths derived from the SimSmoke simulation model for the period 2001–2016. The net economic benefit (monetised benefits minus expenditures) and ROI associated with these policies were determined from the government and societal perspectives. Sensitivity analyses were conducted to check the robustness of the result. Costs were expressed in 2019 Canadian dollars.ResultsThe total of provincial and federal expenditures associated with the implementation of tobacco control policies in Canada from 2001 through 2016 was estimated at $2.4 billion. Total economic benefits from these policies during that time were calculated at $49.2 billion from the government perspective and at $54.2 billion from the societal perspective. The corresponding ROIs were $19.8 and $21.9 for every dollar invested. Sensitivity analyses yielded ROI values ranging from $16.3 to $28.3 for every dollar invested depending on the analyses and perspective.ConclusionsThis analysis has found that the costs to implement the Canadian tobacco policies between 2001 and 2016 were far outweighed by the monetised value associated with the benefits of these policies, making a powerful case for the investment in tobacco control policies.

In Search of Indicators for Assessing Smart and Sustainable Cities and Communities' Performance

2019 ◽  
pp. 265-295
Author(s):  
Anastasia Stratigea ◽  
Akrivi Leka ◽  
Maria Panagiotopoulou
Keyword(s):  
Selection Process ◽  
Smart Cities ◽  
Indicator System ◽  
Urban Environments ◽  
Sustainability Indicators ◽  
City Development ◽  
Sustainable City ◽  
Policy Makers ◽  
Support Policy ◽  
Indicator Sets

The goal of the paper is to elaborate on sustainability aspects of smart sustainable urban environments. More specifically, at a first step the paper aims at critically reviewing globally initiated state-of-the-art approaches for assessing smart cities' performance as to sustainability objectives. The scope of this effort is to identify sets of indicators used in different approaches as well as convergence/divergence among them. Secondly, an attempt to integrate different indicator sets into a more enriched and coherent indicator system is carried out which, by effectively embedding smart and sustainable city development into sustainability indicators' sets, can be used by various types of cities' examples. Finally, the rationale of the indicators' selection process is depicted, in order to support policy makers and planners' guidance towards choosing an appropriate, city-specific set of sustainability indicators for carrying out relevant assessments.

The Weather Roulette: A Game to Communicate the Usefulness of Probabilistic Climate Predictions

2019 ◽  
Vol 100 (10) ◽  
pp. 1909-1921 ◽  
Author(s):  
Marta Terrado ◽  
Llorenç Lledó ◽  
Dragana Bojovic ◽  
Asun Lera St. Clair ◽  
Albert Soret ◽  
...  
Keyword(s):  
Decision Making ◽  
Return On Investment ◽  
Climate Science ◽  
Skill Score ◽  
Economic Benefits ◽  
Business Sector ◽  
Weather Forecasts ◽  
Climate Anomalies ◽  
Forecast Quality

AbstractClimate predictions, from three weeks to a decade into the future, can provide invaluable information for climate-sensitive socioeconomic sectors, such as renewable energy, agriculture, or insurance. However, communicating and interpreting these predictions is not straightforward. Barriers hindering user uptake include a terminology gap between climate scientists and users, the difficulties of dealing with probabilistic outcomes for decision-making, and the lower skill of climate predictions compared to the skill of weather forecasts. This paper presents a gaming approach to break communication and understanding barriers through the application of the Weather Roulette conceptual framework. In the game, the player can choose between two forecast options, one that uses ECMWF seasonal predictions against one using climatology-derived probabilities. For each forecast option, the bet is spread proportionally to the predicted probabilities, either in a single year game or a game for the whole period of 33 past years. This paper provides skill maps of forecast quality metrics commonly used by the climate prediction community (e.g., ignorance skill score and ranked probability skill score), which in the game are linked to metrics easily understood by the business sector (e.g., interest rate and return on investment). In a simplified context, we illustrate how in skillful regions the economic benefits of using ECMWF predictions arise in the long term and are higher than using climatology. This paper provides an example of how to convey the usefulness of climate predictions and transfer the knowledge from climate science to potential users. If applied, this approach could provide the basis for a better integration of knowledge about climate anomalies into operational and managerial processes.

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