718 Investigating Decreased Positive Airway Pressure Compliance in a Veteran Affairs Sleep Medicine Clinic During the 2020 Pandemic

Introduction Positive airway pressure (PAP) compliance for the treatment of sleep apnea at the Albuquerque Veterans Affairs (VA) Sleep Medicine clinic has been observed to be lower in new setup patients after the onset of the COVID-19 pandemic. The reasons for decreased PAP compliance during the COVID-19 pandemic are unclear. The primary outcome will be to identify if there is a common reason that patients at the Albuquerque VA were less compliant with PAP after the onset of the COVID-19 pandemic. Methods Compliance data for 4/1/2020 through 9/30/2020 was compared to compliance data for 4/1/2019 through 9/30/2019. Compliance after PAP machine setup was confirmed to be lower during the 2020 time period. Noncompliant patients will be selected by setup type, new versus machine replacement, and surveyed for reasons for noncompliance. The survey will be conducted at the Albuquerque VA Sleep Center and will include questions regarding beliefs, barriers, and challenges with the use of PAP therapy during the coronavirus pandemic. The definition for initial PAP compliance will be the use of PAP therapy for greater than or equal to four hours per night on at least 70% of nights. Results For the 6-month time period of 4/1/2019 through 9/30/2019, there were 758 PAP setups at the Albuquerque VA. The 30-day compliance for the 758 setups was found to be 61.4%. Comparatively, for the six-month period of 4/1/2020 through 9/30/2020, there were 462 setups with a 30-day compliance result of 49.7%. A survey consisting of questions designed to elicit barriers to use as well as beliefs regarding PAP and COVID-19 will be administered to 20% (n = 46) of the non-compliant patients who were set up with a PAP machine during the 2020 study period. Conclusion PAP compliance after machine setup was lower at the Albuquerque VA sleep center in 2020 versus 2019 (49.7% versus 61.4%). The reasons for the lower observed compliance are attributed to the effects of the coronavirus pandemic. A random sampling of the non-compliant patients during the 2020 time period will be performed and the results will be presented once available. Support (if any) None

Analytics of machine replacement decisions: economic life vs real options

PurposeDespite the existence of multiple asset replacement theories, the economic life replacement method remains a major practical technique for making rational machine replacement decisions. The purpose of this paper is to bridge this method with comprehensive data analytic tools and make it applicable it to modern business reality with abundant data on operating and replacement costs.Design/methodology/approachThis study employs operations research, discrete and continuous optimization, applied mathematical modeling, data analytics, industrial economics and real options theory.FindingsConstructed stochastic algorithms extend the deterministic economic life method and are compared to the contemporary theory of stochastic asset replacement based on real options and dynamic programming. It is proven that both techniques deliver similar results when the cost volatility is small. A major theoretic finding is that the cost uncertainty speeds up the replacement decision.Research limitations/implicationsThis research suggests that the proposed stochastic algorithms may become an important tool for managerial decisions about replacement of many similar machines with detailed data on operating and replacement costs.Originality/valueCompared to the real options replacement theory, major advantages of the proposed algorithms are that they work equally well for any distribution of age-dependent stochastic operating cost. The algorithms are tested on a real industrial case about replacement of medical imaging devices. Numeric simulation supports obtained analytic outcomes.

Employment Opportunities And Human Resources Development In Digital Era: A Case Study In Industrial Sector

Transformation of digitalization in large industries has an impact on the automation of production equipment, including the replacement of production machines from conventional machines (manual) to digital machines. Meanwhile, automation of production equipment requires workers with higher skills, in fact the existing workforce does not have expertise in carrying out all-digital equipment. The impact is a reduction in labor (layoffs). Machine replacement is done in stages so that the reduction of workforce (PHK) in bulk is not visible. However, the inconsistency between the preparation in the world of education and the needs in the world of work continues to occur today. Until now, vocational development based on local resources has not been operating optimally and needs serious attention from the local government. The government on various occasions mentioned four leading sectors that will be strengthened in the development of vocational institutions, namely maritime, tourism, agriculture (food security), and the creative industry. In addition, the government is also developing a policy scheme for Skill Development Funds (SDF), which is a skills improvement program for workers affected by automation (PHK), including through Vocational Training Center (BLK).

Strategic Timing of Investment over the Business Cycle: Machine Replacement in the US Rental Industry

We analyze a data set containing rental revenues, maintenance costs, and sale prices of five different types of rental machines to econometrically estimate key relationships needed to implement a dynamic programming model of the optimal timing of replacement of rental equipment owned by a large multi-location firm in the equipment rental industry. The model reveals significant potential to improve rental company profitability by improving the strategic timing of equipment replacement. The gains from the optimal replacement strategy come from exploiting seasonal variation in rental demand and the timing of the business cycle due to their effects on rental revenues and the cost of replacement. For some machines we find the optimal replacement strategy is procyclical, but for others we find that a countercyclical replacement strategy –- where replacements are concentrated in slow periods of the business cycle –- can significantly increase firm profits.

Methodology for Enhancement of Energy Efficiency in Hydraulic Equipment

The cost of energy has increased greatly in the last decades, even with technological impact attenuators, which brings a concern with the increase of production effectiveness and better use of energy by machines and advanced equipment in industrial plants. This article proposes a methodology that allows a more rational use of energy in the production environment, applying Automation Technology, which represents a more affordable approach in relation to the high capital demanding complete machine replacement by the latest highest efficiency version available. The methodology thus contribute to reducing capital consumption, reducing costs, impacting both in the productive and financial performance of the organizations, with the overall result meaning less damage to the environment, providing sustainable gains.