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Bioregenerative Life Support Systems (BLSS) are a key facet of plans for long term habitats on other celestial bodies. With the Artemis program headed to the moon and SpaceX pushing towards Mars the roadmap is about 10–20 years. Therefore it is vital to consider how BLSS will work with the traditional physicochemical Environmental Control and Life Support Systems (ECLSS). Biological systems are complicated. Their inputs and outputs cannot be turned on and off the way physicochemical systems can. Therefore the accurate monitoring and prediction of these systems is fundamental to integrating the BLSS into the life support system as a whole. This paper will summarize the history of BLSS research, the system requirements for integrating a BLSS into the ECLSS, and the research needed to meet these requirements. As the world looks towards the future of humans living on other celestial bodies, there is a lot of work to do to support keeping them safe and healthy. Bioregenerative Life Support Systems have potential to provide massive support, if they are effectively integrated with the physicochemical systems. • Explores the systems requirements of physicochemical and bioregenerative systems. • Provides updated equivalent system mass estimates using LED lighting technologies. • Calculates return on investment time for bioregenerative food production. • Suggests future research directions for bioregenerative life support systems (BLSS). [ABSTRACT FROM AUTHOR]

Pancreatic cancer has the highest growth in incidence among patients aged ≥80 years. Discharge destination after hospitalization is increasingly recognized as a marker of return to baseline functional status. Our aim was to identify the preoperative and intraoperative predictors of non-home discharge in those aged 80 or older. The ACS-NSQIP pancreas-targeted database was queried to identify patients aged ≥80 years who underwent pancreatoduodenectomy (PD) from 2014 to 2020. Home discharge (HD) versus non-HD cohorts were compared using univariate logistic regression. Multivariable logistic regression was used to identify predictors of non-HD. Non-HD was over twice as likely to occur in patients aged ≥80 years than in those aged 65–79 years (p < 0.01). Comorbidity factors significantly associated with non-HD in patients aged ≥80 years included COPD, hypertension, HF, lower preoperative albumin, but not obesity. Non-comorbidity factors included older age, female gender, ASA III–IV, preoperative dependent functional status, and transfer origin before PD. Individuals ≥80 years have possibly delayed or lower rate of return to baseline functional status following PD compared to those aged 65–79 years. Predictors of non-HD can be identified to facilitate preoperative counseling and discharge planning, thus enhancing care workflow efficiency. [Display omitted] [ABSTRACT FROM AUTHOR]

Surgery performed at night and on weekends is thought to be associated with increased complications. However, the impact of time of day on outcomes has not been studied within cranial neurosurgery. We aim to determine if there are differences in outcomes for cranial neurosurgery performed after hours (AH) compared with during hours (DH). We performed a single-center retrospective study of cranial neurosurgery patients who underwent emergent surgery from January 2015 through December 2019. Surgery was considered DH if the incision occurred between 8 am and 5 pm Monday through Friday. We assessed outcome measures for differences between operations performed DH or AH. Three-hundred and ninety-three patients (114 DH, 279 AH) underwent surgery. There was a lower rate of return to the operating room within 30 days for AH (8.6%) compared with DH (14.0%), P = 0.03, on multivariate analysis. There were no significant differences in length of operation, estimated blood loss, improvement in Glasgow Coma Scale, intensive care unit and total hospital length of stay, 30-day readmission, 30-day mortality, and in-hospital mortality for cases performed DH compared with AH. Further subgroup analyses were performed for patients who underwent immediate surgery for subdural hematomas, with no differences noted in outcomes on multivariate analysis. This study suggests that operating AH does not appear to negatively impact outcomes when compared with operating DH, in cases of cranial neurosurgical emergencies. Further study assessing the impact on elective neurosurgical cases is required. [ABSTRACT FROM AUTHOR]

This study evaluated the economic feasibility and environmental sustainability of producing nutritionally superior snacks on an industrial scale by supercritical fluid extrusion (SCFX) using milk protein concentrate (MPC81-AP) or starch (Starch-AP)-based formulations enriched with apple pomace powder. Selected nutrient contents and antioxidant attributes were also studied to highlight the nutritional qualities of the final products. For large-scale implementation using a low-temperature (85 °C) and low-shear SCFX system, capital budgeting, breakeven point, and profitability ratios were determined. During a standard 12-hour production run, a substantial margin of safety of 29.03% and a breakeven point of 0.71 years were estimated, indicating resilience against potential losses and a swift return on investment. The projected prices for MPC81-AP and Starch-AP-based products were $30.13/kg (Similar market snacks, $32-150/kg) and $26.29/kg, respectively. In summary, both formulations exhibited superior nutritional qualities, better gross profit margins and return on investment with environmentally sustainability, compared with the conventional extrudate snack foods available in the market today. [ABSTRACT FROM AUTHOR]

Latin America faces a shortage in radiation therapy (RT) units and qualified personnel for timely and high-quality treatment of patients with cancer. Investing in equitable and inclusive access to RT over the next decade would prevent thousands of deaths. Measuring the investment gap and payoff is necessary for stakeholder discussions and capacity planning efforts. Data were collected from the International Atomic Energy Agency's Directory of Radiotherapy Centers, industry stakeholders, and individual surveys sent to national scientific societies. Nationwide data on available devices and personnel were compiled. The 10 most common cancers in 2020 with RT indication and their respective incidence rates were considered for gap calculations. The gross 2-year financial return on investment was calculated based on an average monthly salary across Latin America. A 10-year cost projection was calculated according to the estimated population dynamics for the period until 2030. Eleven countries were included in the study, accounting for 557,213,447 people in 2020 and 561 RT facilities. Approximately 1,065,684 new cancer cases were diagnosed, and a mean density of 768,469 (standard deviation ±392,778) people per available unit was found. By projecting the currently available treatment fractions to determine those required in 2030, it was found that 62.3% and 130.8% increases in external beam RT and brachytherapy units are needed from the baseline, respectively. An overall regional investment of approximately United States (US) $349,650,480 in 2020 would have covered the existing demand. An investment of US $872,889,949 will be necessary by 2030, with the expectation of a 2-year posttreatment gross return on investment of more than US $2.1 billion from patients treated in 2030 only. Investment in RT services is lagging in Latin America in terms of the population's needs. An accelerated outlay could save additional lives during the next decade, create a self-sustaining system, and reduce region-wide inequities in cancer care access. Cash flow analyses are warranted to tailor precise national-level intervention strategies. [ABSTRACT FROM AUTHOR]

Femoroacetabular impingement (FAI) is common among the active and young population. The present study analysed the rate of return to sport, related influencing factors, and the sport activity level according to the Hip Outcome Score - Sport-Specific Subscale (HOS-SSS). The literature search was performed in December 2020. All clinical trials investigating HOS-SSS and/or return to sport after arthroscopic treatment for FAI were considered for inclusion. The outcomes of interest were to analyse the rate of return to sport and the sport activity level according to the HOS-SSS in patients who underwent arthroscopic osteoplasty for FAI. Data from 41 studies (4063 procedures) were retrieved. A total of 88.75% (581 of 655) of patients returned to sports within a mean of 37.4 ± 16.5 months. The HOS-SSS score improved from 45.0 ± 10.6 to 73.1 ± 9.5 (P < 0.0001) at last follow-up. The following baseline characteristics evidenced positive association with post-operative activity level: lighter weight (P = 0.01), younger age (P = 0.001), Tönnis angle grade I (P = 0.009), greater HHS (P = 0.01), NAHS (P < 0.0001) and HOS-ADL (P = 0.01). Arthroscopic treatment for FAI resulted in excellent results in terms of return to sport. Moreover, lighter weight and younger age, greater HHS, NAHS, HOS-ADL at baseline were positively associated with post-operative sport activity level. IV, systematic review. [ABSTRACT FROM AUTHOR]

This paper presents a local energy exchange mechanism to benefit residential customers and retailers under variable wholesale market spot prices. To do so, a peer-to-peer (P2P) trading-enabled local energy market (LEM) is proposed to facilitate frequent energy transactions among participants. The proposed LEM mechanism considers market operational constraints and maximises electricity cost reductions. Further, the proposed LEM optimises the customers' investment return for battery energy storage systems (BESSs) and minimises retailers' financial losses during higher spot prices in the wholesale market. Finally, a case study is demonstrated using real-world Australian data in which P2P trading is performed between interested buyers and sellers. Two scenarios with high and low wholesale market spot prices are analysed comprehensively considering five metrics such as solar-to-spot (STS); solar-to-load (STL); forward buy contract (FBC)-to-load (FBC-L); spot-to-load (Short); and FBC-to-spot (Long). The simulation results reveal that the customers reap substantial benefits from the proposed LEM in contrast with business-as-usual (BAU), allowing them to expedite BESS investment returns. Also, the proposed LEM helps a retailer decrease the effect of higher spot prices by reducing its unexpected financial losses while improving self-consumption and self-sufficiency in the local energy network. • Proposing a spot price-aware local energy exchange framework. • Incorporating a retailer and a network operator into the proposed model. • Examining the impact on retailer's energy exchange during unstable spot prices. • Assessing the financial benefits offered to customers and stakeholders. • Evaluating how battery investment returns of customers are impacted. [ABSTRACT FROM AUTHOR]

• An optimal dispatch model for DN with 5G BSs based on cooperative game is established. • An adaptive aggregation method for 5G BSs is proposed. • Electrical coupling degree and communication service similarity are introduced for 5G BSs aggregation. • A cost allocation interval based on marginal benefit and investment return is constructed. Leveraging the dispatchability of 5G base station energy storage (BSES) not only enables the mobile network operator (MNO) to gain additional revenue, but also facilitates the integration of renewable energy sources in distribution network (DN). However, since BSES and DN are owned by different stakeholders, integrating BSES into DN operations poses significant challenges. In this regard, this paper proposes a DN optimal dispatch model that incorporates the adaptive aggregation of 5G base stations (BSs) through a cooperative game framework. Firstly, the dispatchability of BSESs is analyzed and modelled. Considering it is difficult to dispatch every single unit optimally, an adaptive aggregation model of 5G BSs is established, where the electrical coupling degree and the communication service similarity are taken as comprehensive metrics. On this basis, an optimal dispatch model of DN based on cooperative game is constructed, where the total operational costs of 5G BSs and DN are considered as the characteristic function. The number of 5G BS clusters and the aggregating results are adjusted adaptively during optimization. The optimal aggregation of 5G BSs is achieved using the Affinity Propagation (AP) clustering algorithm. Furthermore, to solve the optimal dispatch model of the DN with enhanced computational efficiency, the particle swarm optimization algorithm integrated with second-order cone programming (PSO-SOCP) is employed. After dispatching, the benefit allocation between MNO and distribution system operator (DSO) is conducted using the Shapley value method and the Equal Profit Method to obtain an entire range of allocation results. Finally, simulations are carried out with results proving the effectiveness of the proposed method. [ABSTRACT FROM AUTHOR]

The ongoing energy transition towards renewable sources faces reliance on fossil fuels throughout their life cycle, primarily due to mining and material production for infrastructure. This study proposes the Renewable Exergy Return on Investment (RExROI) metric, which quantifies the renewable exergy obtained from each unit of non-renewable exergy invested in energy systems. It can be seen as a Renewation Index, applicable to any energy production system, indicating the degree of renewability of such technologies. Focused on silicon photovoltaic panels, the study explores five material intensities, nine scenarios based on the capacity factor and lifespan, and two alternatives for electricity used in the manufacture. Results show that material intensity increases RExROI from −0.6 MJ/MJ (non-renewable exergy is higher than electricity produced) to 5.7 MJ/MJ, increasing until 19 MJ/MJ with the best location and lifespan, and reaching 34 MJ/MJ if renewable electricity is used in manufacturing. Thus, carbon intensity can range from 734 to 7 gCO 2 eq/kWh. Furthermore, some strategies to enhance RExROI are discussed based on the (i) energy sources, (ii) materials, and (iii) production stages of photovoltaic panels. Thus, this study demonstrates the usefulness of RExROI in evaluating the energy-material-emission nexus of energy systems through exergy in the context of energy transition. [Display omitted] • RExROI compares actual renewable exergy generated with non-renewable invested. • PV panels RExROI multiplied by three with the best location lifespan. • PV panels RExROI increase in 80 % using renewable electricity in their production. • Exergy cost disaggregation is essential to analyze RExROI improvement strategies. • RExROI concept is applicable to any energy system. [ABSTRACT FROM AUTHOR]

• Source-grid-load-storage multi-flexible resources are incorporated into the flexible planning model considering flexible ramp capacity. • Various flexibility resource investment priorities and potential were evaluated concerning flexibility resource characteristics. • The impact of renewables penetration levels on cost performance and the benefits of the flexibility resource portfolio allocation are quantitatively assessed. With rapidly increasing levels of renewable energy penetration, flexibility resources play an ever more critical role in the future power system. This paper describes a two-stage stochastic mixed integer second order cone (MISOC) method for flexibility resource planning (VFRP) considering source-grid-load-storage interactions. Considering renewable energy penetration levels and flexibility resource characteristics, this study quantifies the extent to which the share of renewable energy generation affects cost performance, and assesses the priority and potential of investing in flexibility resources. Moreover, the multi-type flexibility resource portfolio allocation method and energy storage only approach are compared in terms of socio-economic benefits. A multi-cut Benders-based approach is used for decomposing large-scale stochastic expansion planning problems to reduce the computational burden. Numerical simulation tests on the modified energy test systems I39G20 and F213G20 verified the correctness and effectiveness of the proposed flexible resource planning models and solution algorithms. The simulation results show that retrofit of coal-fired units for better flexibility has a higher investment return. Still, energy storage presents a tremendous investment prospect and potential. Finally, the multi-type flexibility resource portfolio allocation method is more cost-effective than an energy storage only approach. [ABSTRACT FROM AUTHOR]

Measuring the limitations of transitioning to 100% renewable energy systems partly equates with the capability of quantifying associated net-energy production. To foresee future possibilities, an advanced systemwide energy-return-on-investment (EROI) model was constructed. Driven by the thorough consideration of the existing weaknesses of EROI, the model integrates the concept of energy statistics, life cycle assessment techniques and energy system modelling in order to overcome the underlying primary energy quality issues, boundary condition problems and energy system design related uncertainties that compromises comparability of EROI during the energy transition. This model was applied to the Israeli power system that presents a unique opportunity to examine the vulnerability of depending on limited resources and the connection of EROI to system design. This study demonstrates the dependency of EROI on the energy transition path, system design requirements expressed via interactive linkages of curtailment, variable renewable energy penetration and storage system design, and resource diversity. Achieving a very high variable renewable energy penetration by 2050 with solar photovoltaics carries a risk of falling below an EROI value of 10, such vulnerability can be largely minimised by well-conducted manoeuvring of the system design and resource diversification. Despite the large uncertainty of this study, the need for a multicriteria designing technique is out of the question. • An advanced systemwide EROI model suitable for studying transitions is presented. • EROI trend depends on transition paths and system design differences. • EROI bottoms out for system designed without curtailment. • Very high solar photovoltaics penetration of up to 100% carries sustainability risk. • Multicriteria system design and resource diversification can circumvent the risk. [ABSTRACT FROM AUTHOR]

Arid forests in the American West contend with overly dense stands and a need to reduce fuels and restore more natural fire regimes. Forest restoration efforts include fuel treatments, such as thinning and prescribed burning, that can reduce ground and ladder fuels. Restoration and fuel treatments have emerged as leading wildfire risk-reduction strategies in the American West, yet little is known about the cost-effectiveness of such programs. To evaluate forest restoration and fuel treatment benefits and costs, we conducted a meta-analysis of benefit-cost ratios for restoration benefit types documented in the literature for Western U.S. dry mixed conifer forests at risk of uncharacteristic wildfires. A total of 120 observations were collated from 16 studies conducted over the last two decades, with benefits ranging from enhanced ecosystem services to extensively avoided wildfire costs. Significant variation in the value of restoration and fuel treatment benefit types was found, indicating that restoration benefits differ in value based on societal importance. Overall, 17 individual benefit types were aggregated to show that in the most valuable and at-risk watersheds, every dollar invested in forest restoration can provide up to seven dollars of return in the form of benefits and provide a return-on-investment of 600%. [ABSTRACT FROM AUTHOR]

Numerous studies have affirmed that artificial intelligence (AI) can effectively enable energy savings in factories. However, there is currently a lack of explicit research that identifies the energy-saving effects of AI methods as compared to the conventional practices employed in factories, which involve the replacement of equipment with high energy efficiency (non-AI method), with respect to variance in the effectiveness. Thus, this ignited the motivation for this study, wherein the research team developed a "Universal AI workflow for energy saving" which adopted a standard workflow of "learning, Modeling, and Prediction." Additionally, a three-year research project was launched to conduct empirical tests in ten factories, comparing the efficacy differences between AI and Non-AI methods. In 2021, research team established the energy consumption baselines for each factory through data collection; the entirety of 2022 was dedicated to AI integrations; and energy-saving benefits were evaluated in 2023. During the research period, each factory also implemented other non-AI energy-saving methods which were juxtaposed with AI approaches for comparison. Our study results showed that average AI-enabled energy savings across the ten factories amounted to 106,124 kWh/yr, while average energy savings from non-AI methods amounted to 1,231,625 kWh/yr. Despite the inferior energy-saving results, the AI methods had an average return on investment (ROI) of 0.46 years while non-AI methods had an average ROI of 6.22 years, indicating that AI methods could recover the investment costs through energy savings in less than one year. It is also worth noting that the ten factories produced a diverse range of products encompassing wafers, steel, and foods, but the AI methods used for energy saving employed the same workflow. By contrast, the non-AI methods necessitated distinct workflows and detailed engineering adjustments. It can be inferred from these empirical findings that AI techniques for achieving energy-saving control in factories can be integrated using standardized processes. In summary, AI methods can facilitate standardized workflows in factories and offer substantial energy-saving benefits that can typically cover investments within a year. AI represents a highly viable energy conservation option for factories seeking to maintain uniformity in product processes and realize efficient ROIs. • Conducted case studies across ten factories. • Compared the energy-saving effects of implementing AI versus traditional hardware upgrades (non-AI methods). • The annual energy savings from AI were less than one-tenth of those achieved through non-AI methods. • However, the ROI of AI-based energy savings significantly outperformed non-AI methods. • AI methods can facilitate standardized workflows in factories, making it more convenient to implement energy savings. [ABSTRACT FROM AUTHOR]

[Display omitted] • A solventless recovery of grease from sewage sludge was designed. • A very high yield of grease recovery was achieved (up to 70 wt%). • Final dewatered sludge resulted in 15 % less than the amount conventionally obtained. • A price of 800–900 € per ton of grease would guarantee the economic sustainability. For the first time, the recovery of lipids from urban sewage sludge was investigated through a solvent-free process based on elementary operations validated on a pilot scale (2 tons per hour). Sedimented sewage sludge was dewatered through centrifugation, acidified (and in the case treated with hydrogen peroxide), heated to 80 °C and centrifuged to obtain three different streams: i) raw grease, ii) exhausted aqueous phase, and iii) dewatered sludge. The recovery yield of grease from sludge could reach a very high value (70 wt%), depending essentially on the initial lipid content in sewage sludge, which was monitored and found to range between 1.1 and 6.6 wt% (13–25 wt% with respect to TS). The use of H 2 O 2 played a crucial role in the recoverability of lipids and the relevant pureness in free fatty acids content (>89 wt%). In addition, the total solids content in the exhausted aqueous phase and the final residual sludge were sensibly affected by using H 2 O 2. Final dewatered sludge had a very high content of solids (TS 31.0 ± 2.3 wt%) and resulted in 15 % less of the amount of sludge conventionally obtained from anaerobic digestion. According to these figures, for medium wastewater treatment plants, a selling price of 800–900 Euro per ton of grease would guarantee a return on investments within three years of operations. This simple procedure represents a quick and proficient way to treat sewage sludge, turning it into a valuable feedstock for fine chemicals, in agreement with Circular Bioeconomy principles. [ABSTRACT FROM AUTHOR]

Background: The present systematic review investigated return to sport, patient reported outcome measures (PROMs), complications and subsequent progression to total hip arthroplasty (THA) in patients undergoing arthroscopic labral repair for FAI.Material and Methods: Following the PRISMA statement, the literature search was performed in February 2021. The outcomes of interest were: rate of return to sport, modified Harris Hip Score (mHHS), the subscales Activities of Daily Living and Sport-Specific Subscale of the Hip Outcome Score (HOS-ADL and HOS-SSS, respectively). Complications, revision surgeries and progression to total hip arthroplasty were recorded.Results: Data from 210 procedures were retrieved. The mean follow-up was 34.0 (24.0-42.5) months. The mean age of the patients was 32.0 (20.0-47.0) years, while the mean BMI was 20.9 (20.1-21.7) kg/m2. 52.8% (111 of 210 patients) were women. At 24-month follow-up, 100% of the patients had returned to sport. At a mean of 34 months follow-up, the mean mHHS increased by 25.5% (P = 0.02), the mean HOS-ADL by 23.0% (P = 0.03), the mean HOS-SSS by 32.8% (P = 0.001). No complications were observed. The rate of revision was 4.3% (9 of 210 procedures). At a mean of 37.9 ± 7.5 months, 1.9% of patients (4/210) underwent THA.Conclusion: Arthroscopic labral refixation for FAI yields reliably positive clinical outcomes, with a low rate of revision and conversion to THA. [ABSTRACT FROM AUTHOR]

The number of wastewater treatment plants (WWTPs) in China is fast growing as the country's urbanization accelerates. WWTPs, part of the high-energy-consumption industry, must use a lot of energy in wastewater treatment. PV projects in WWTPs are viable solutions for energy conservation, but PV project investors, WWTP owners, and government authorities need to conduct rigorous economic and ecological assessments. This article examines the PV potential, financial feasibility, energy savings, and emission reduction effect of large-scale WWTPs in China using the cable-supported system. Furthermore, China's total PV power potential for urban WWTPs has been assessed at 5.6 GW for the first time. According to economic feasibility analysis, 26 of the 31 WWTP-PV projects in China's various regions are economically viable. Moreover, the WWTP-PV projects can assist WWTP in reducing carbon emissions by 10%–40%. Further sensitivity analysis reveals that practically all WWTP-PV projects will be viable in the future, assuming that certain solar resource requirements are met, and appropriate investment strategies are implemented. • China has a total PV power potential of 5.6 GW for urban WWTPs. • The economic feasibility analysis shows most WWTP-PV projects in China are viable. • The WWTP-PV project can help WWTP reduce carbon emissions by 10%–40%. • The PV potential of a WWTP is correlated with its planned wastewater treatment capacity. [ABSTRACT FROM AUTHOR]

The existence of organic matters in naturally hydrate-bearing sediments would notably impact the CH 4 extraction from reservoirs via CO 2 swapping. In this work, the depressurization-assisted flue gas replacement was explored with artificial hydrate-bearing clay-silt sediments containing organic matter. The effect of organic matter type and content, depressurization moment and amplitude was systematically investigated. The results showed that the replacement was promoted at 5.0 wt% sulfonated lignin (SL) before depressurization, while it was inhibited at a lower SL content and this inhibition was weakened after depressurization. The CH 4 replacement ratio and CO 2 sequestration ratio increased as the fulvic acid (FA) content increased. For the organic matter-contained systems, the earlier depressurization moment was conducted, the higher CH 4 recovery was obtained. The CH 4 replacement ratio increased with the increase of depressurization amplitude, which reached 71.48 % in the 3.0 wt% FA system at the depressurization amplitude of 3.0 MPa. Aspen simulation revealed that the energy consumption was mainly caused by compression, there exist an optimum injection pressure of flue gas for the energy return on investment. The findings provide useful information for the depressurization-assisted flue gas replacement and would contribute to the actual NGH exploitation in the future. [Display omitted] • Depressurization-assisted flue gas replacement was explored with artificial hydrate-bearing clay-silt sediments. • Effects of organic matter type and content, depressurization moment and amplitude were investigated. • Early depressurization moment in organic matter-contained systems contributed to CH 4 recovery. • Aspen simulation revealed that energy consumption was mainly caused by compression. [ABSTRACT FROM AUTHOR]

• Domain experts of 12 large pharma companies provide their perspectives on QC. • QC's scientific potential may not translate into unprecedented investment return. • To institutionalize QC, education, collaborations and use cases need to be tackled. • Management commitment and organizational culture required to institutionalize QC. Innovative pharmaceutical companies have started to explore quantum computing (QC). In this article, we provide a collective industry perspective from QC domain leaders at leading pharmaceutical companies. There are immediate nonfinancial benefits in engaging with QC, some likely financial returns in the short term in drug development, manufacturing, and supply chain, and potentially large scientific benefits in drug discovery long term. We discuss the required activities for institutionalizing QC: how to create an understanding of QC among researchers and management, which and how to deploy external resources, and how to identify the problems to be addressed with QC. If (and once) deployable, QC will likely have a similar trajectory to that of computer-aided drug design (CADD) and artificial intelligence (AI) during the 1990s and 2010s, respectively. [ABSTRACT FROM AUTHOR]

• The fiscal efficiency of waste treatment PPP was studied. • The impact of demand risk taking on the fiscal expenditure was discussed. • VfM and sensitivity analysis was performed by using Korean cases. • Cost structure and demand risk should be considered for fiscal efficiency of PPP. This study aimed to examine the government's cost efficiency considering the high-risk/high-return mechanism of PPP. Faced with increasing demand but with limited budget, the Korean government has relied on the Public-Private Partnership (PPP) to provide waste treatment services for the last couple of decades to expand fiscal space. However, most of waste treatment facilities projects have been promoted using the BTO (Build-Transfer-Operate) method with high rate of return due to the demand risk that is transferred to the private. We performed a conversion analysis of a BTO to a BTL (Build-Transfer-Lease) method, in which demand risk is borne by the government, for 18 PPP waste treatment cases with actual operation records. The result of comparing the life-cycle costs of government in employing each project method shows that the BTL can provide 5.26% of Value for Money (VfM) compared to the BTO as the government takes the demand risk and lowers the required rate of return of the private. This implies that transferring the demand risk to the private sector may not always be the best option for the government. From the government's perspective, instead of transferring the demand risk to the private and providing a high rate of return, the government can retain the demand risk and reduce the rate of return, and it can be fiscally more advantageous considering the cost structure of each PPP method. Through Korean PPP waste treatment cases, this study suggests that policy makers who implement PPP should consider the government's strategic risk sharing by understanding the predictability of demand and the nature of cost structure of each PPP method. [ABSTRACT FROM AUTHOR]

Background: Emergency medical services (EMS) diversion strategies attempt to limit the impact of low-acuity care on emergency department (ED) crowding, but evidence supporting these strategies is scarce.Objective: This study aims to measure the effect of a treat-in-place and alternative destination program on ED transports and EMS utilization.Methods: We used a natural experiment study design to measure effects of a pilot prehospital diversion program on ED transport, number of EMS vehicles dispatched, and EMS time on task for low-acuity emergency calls in a midsized urban setting characterized by a high prevalence of health disparities, concentrated poverty, and limited access to primary care between October 2018 and January 2020. We also used direct variable cost to estimate the return on investment attributable to avoided ED visits.Results: Of 3725 calls that met eligibility criteria, the program responded to 1084 (29.1%), with 56.7% of those resulting in an ED visit, compared with 64.6% of the 492 control calls that were eligible but were dispatched when program services were unavailable. Of 1084 calls receiving response, 213 (19.6%) were enrolled in the program, and 8.5% of those were transported by EMS to the ED. Adjusted results show EMS time on task was 23.4 min less for enrolled calls vs. controls. The program can achieve a positive return on investment by enrolling 2.9 patients/day.Conclusions: A prehospital diversion program reduced ED visits and EMS transport times. Improved targeting of patients for enrollment would further increase the intervention's efficacy and cost savings. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to address STM through an unconventional but pragmatic angle to help optimize efficient compliance governance. This paper proposes using antitrust mechanisms in space as a pragmatic and utilitarian tool for sustainable purposes with regards to STM within a soaring space ecosystem. In the context of accelerated space commercialization and privatization, having a new space antitrust framework at the helm of such transition might indeed prove to be a flexible yet decisive tool into shaping the future of STM and ensuring perennial protection of higher space principles which are enshrined in the Outer Space Treaty and form the essence of space law. On one hand, examples of antitrust key components include fair competition while, on the other hand, higher ethical principles of space law include non-discrimination and benefits sharing. Furthermore, in between these two extremes, security and commerce both rely, respectively on non-harmful interference and competitiveness. To navigate through all these factors, a new space antitrust framework might indeed prove strategic and beneficial to incentivizing the creation of an adaptive, polycentric and action-oriented governance mechanism with great resonance among the commercial new space players and reaffirm the importance of sustainable space traffic management before return on investment, while still making a profit in the long run. [ABSTRACT FROM AUTHOR]

[Display omitted] • Cost benefit analysis of a municipal solid waste recycling facility. • Internal Rate of Return and Net Present Value of a project. • MATLAB, Python and R-Studio for comparation and validation. Rapid population and economic growth, changes in consumption pattern etc. have become major contributing factors to severe municipal solid waste generation globally. Thus, various methods are being employed to manage the incessant municipal solid waste generation for a sustainable solid waste management and one of the viable approaches is the recycling option. The main objective of this paper is to determine the cost benefit analysis of setting up a recycling facility for the processing of various wastes for use as raw materials by industries. The cost benefit analysis was carried out based on historic data obtained from the municipality and some recent waste composition data. The overall analysis was done using Excel software. From the Excel software analysis, Internal Rate of Return on investment was 42%, Internal Rate of Return on equity was 98% and Net Present Value was R 63, 420,000 (USD$ 4646225.33). In ascertaining the result obtained from the Microsoft Excel, three data analysis and technical computing software (MATLAB, Python, and R-Studio) were employed. This was necessary to compare and validate the cost-benefit indicators (Net Present Value and Internal Rate of Return). Besides, evaluating the performance of each software with regards to the cost-benefit evaluation is ideal for a recycling plant like this to establish the feasibility of the project. Moreover, sensitivity analysis was conducted, and a breakeven point of 211 tons of waste was obtained. In addition, the total benefit of recycling was valued and was given as R 486,008,582.85 (USD$ 35605572.16). From the overall analysis, it was observed that the IRR and Net Present Value were alike, about 677 potential jobs could be created on the project and the Net Present Value > 0. Based on the overall analysis, it was concluded that the project is viable. [ABSTRACT FROM AUTHOR]

This aim of this paper is to set the scene for the need for impact assessment and return on investment in funded cardiovascular research in Australia, starting with the historical perspective on waste in health and medical research. Recently there has been a substantial move from discussion and policy about the need for research translation, into practice and application via the evolution of funding streams like the Australian Medical Research Future Fund (MRFF). Health and medical research funders play a critical role in both setting the expectations for research translation and impact and helping researchers to meet these expectations. As a leading cause of death, cardiovascular disease is a national health priority, recognised as such with a AUD$220 million MRFF allocation to the Cardiovascular Health Mission. Focussing on cardiovascular research, we address some of the barriers researchers face in prospectively planning for research translation and impact assessment, and call for an ecosystem that supports a return on investment for all stakeholders, especially the community and patient end-users. [ABSTRACT FROM AUTHOR]

Using self-reported retail investor information from a risk-return profile survey, we investigate the determinants of individual return objectives as well as the capacity of investors to achieve them. Controlling for a large set of covariates, we provide empirical evidence that return objectives are related to subjective individual characteristics (such as financial literacy and risk tolerance), some sociodemographic variables (age and education), and recent past trading intensity. Retail investors with higher return objectives perform better than their counterparts who want to avoid any risk of capital loss. The capacity to achieve the return objective, however, decreases as the level of the objective increases. [ABSTRACT FROM AUTHOR]

This paper examines the use of survey-based measures in volatility forecasting. We argue that an aggregate volatility forecast built up from individual forecasts should be the sum of individual expected volatilities and the dispersion in mean return forecasts. We use data coming from a repeated survey to capture volatility expectations and mean returns of investors, and to produce aggregate volatility forecasts. Our survey-based volatility forecasts are consistent and quantitatively similar with forecasts based on GARCH and implied volatility models. This result is robust to both in-sample and out-of-sample comparisons and in response to news. [ABSTRACT FROM AUTHOR]

Context: Individuals with noncommunicable diseases account for a disproportionate share of medical expenditures, absenteeism, and presenteeism. Therefore, employers are increasingly looking to worksite wellness programs as a cost-containment strategy. Previous reviews examining whether worksite wellness programs deliver a positive return on investment have shown mixed results, possibly because the more optimistic findings come from studies with poorer methodologic quality. The purpose of this systematic review is to critically revisit and update this literature to explore that hypothesis.Evidence Acquisition: A total of 4 databases were systematically searched for studies published before June 2019. Included studies were economic evaluations of worksite wellness programs that were based in the U.S., that lasted for at least 4 weeks, and that were with at least 1 behavior change component targeting 1 of the 4 primary modifiable behaviors for chronic disease: physical activity, healthy diet, tobacco use, and harmful consumption of alcohol. Methodologic quality was assessed using Consensus for Health Economic Criteria guidelines and the risk for selection bias associated with the study design. Data extraction (September 2019-February 2020) was followed by a narrative synthesis of worksite wellness programs characteristics and return on investment estimates.Evidence Synthesis: A total of 25 relevant studies were identified. After conducting a quality and bias assessment, only 2 of the 25 studies were found to have both high methodologic rigor and lower risk for selection bias. These studies found no evidence of a positive return on investment in the short term.Conclusions: The highest-quality studies do not support the hypothesis that worksite wellness programs deliver a positive return on investment within the first few years of initiation. [ABSTRACT FROM AUTHOR]

Background: Emerging evidence suggests that opioid use for patients with acute low back pain does not improve functional outcomes and contributes to long-term opioid use. Little is known about the impact of opioid administration in the emergency department (ED) for patients with low back pain.Objectives: This study compares 30-day return rates after administration of various pain management modalities for emergency department (ED) patients with low back pain.Methods: We conducted a retrospective multicenter observational study of patients in the ED who were diagnosed with low back pain and discharged home in 21 EDs between November 2018 and April 2020. Patients were categorized based on the pain management they received in the ED and compared with the reference group of patients receiving only nonsteroidal anti-inflammatory drugs, acetaminophen, or a combination of the two. The proportions of ED return visits within 30 d for each medication category was calculated and associations between analgesia categories and proportions of return visits were assessed using logistic regression models to obtain odds ratios (ORs) and 95% confidence intervals (CIs).Results: Patients with low back pain who received any opioid, intravenous opioid, or intramuscular opioid had significantly increased proportions of a return visit within 30 d (32% [OR 1.78 {95% CI 1.21-2.64}]; 33% [OR 1.83 {95% CI 1.18-2.86}]; and 39% [OR 2.38 {95% CI 1.35-4.12}], respectively) when compared with patients who received nonsteroidal anti-inflammatory drugs (19%), acetaminophen (20%), or a combination of the two (8%).Conclusions: Patients receiving opioids were more likely to return to the ED within 30 d than those receiving received nonsteroidal anti-inflammatory drugs or acetaminophen. This suggests that the use of opioids for low back pain in the ED may not be an effective strategy, and there may be an opportunity to appropriately treat more of these patients with nonopioid medications. [ABSTRACT FROM AUTHOR]

The Canary Island archipelago holds 2.2 million inhabitants and received more than 14 million tourist visitors in 2019. Its volcanic origin and the presence of recent volcanic activity highlight its potential geothermal interest for heat production, therefore offering an attractive pathway for a renewable energy supply, not only for power generation and deep geothermal exploitation but also for low-enthalpy heating and cooling production. This work investigates nine touristic infrastructures in the Canary Islands which experienced a transition from conventional heat production systems to shallow geothermal energy (SGE) systems. The SGE systems established consisted in ultra-low temperature district heating and cooling (DHC) micro-networks involving, in most cases, small apartment blocks fed by shallow geothermal plants with an average cooling capacity of 602 kW and a heating capacity of 614 kW. The examination of this transition has exhibited an average saving of 374 MWh, 69,235 € and 280 tCO 2 for each installation every year. This work provides evidence of the economical, energetical and environmental advantages of SGE technology in volcanic islands facing both and enormous heating and cooling demand due to tourism, in an energy-dependent system that also faces the challenge of the decarbonization of the heating production sector. • Nine shallow geothermal systems in Canary Islands were examined. • Transition to shallow geothermal energy resulted in 66% energy savings. • Investments showed return rates higher than 13% for all cases studied. • Emissions savings were 256 tCO 2 per installation and year on average. [ABSTRACT FROM AUTHOR]

• An agent can exploit his private information only after undertaking an investment approved by the principal. • The post-investment inefficiencies affect the principal's decision to assign the agent to invest ex ante. • A better distribution of investment returns can lead to the principal assigning less agents to invest. An agent's private information on his investment return is payoff-relevant only upon investment. This paper studies the contracting and assignment problem of a principal who can assign her agent to invest, which improves the agent's future productivity but allows the agent to exploit his private information for an information rent, or continuously produce, which prevents post-investment adverse selection but causes stagnation in productivity. With moral hazard in production, the optimal incentive contracts induce efficient production by agents without investment, but the improved productivity of any investment is under-exploited. A better distribution of investment returns can worsen inefficiency, with the principal possibly assigning less agents to invest. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the outcomes of planned oocyte cryopreservation patients most likely to have a final disposition.Design: Retrospective cohort study of all patients who underwent at least 1 cycle of planned oocyte cryopreservation between Jan 2005 and December 2009.Setting: Large urban University-affiliated fertility center PATIENT(S): All patients who underwent ≥1 cycle of planned oocyte cryopreservation in the study period.Intervention(s): None MAIN OUTCOME MEASURE(S): Primary outcome was the disposition of oocytes at 10-15 years. Secondary outcomes included thaw/warming types, laboratory outcomes, and live birth rates. Outcomes and variables treated per patient.Result(s): A total of 231 patients with 280 cycles were included. The mean age at the first retrieval was 38.2 years (range 23-45). A total of 3,250 oocytes were retrieved, with an average of 10 metaphase II frozen/retrieval. To date, the oocytes of 88 patients (38.1%) have been thawed/warmed, 109 (47.2%) remain in storage, 27 (11.7%) have been discarded, and 7 (3.0%) have been transported elsewhere. The return rate (patients who thawed/warmed oocytes) was similar by Society for Assisted Reproductive Technology age group. The mean age of patients discarding oocytes was 47.4 years (range, 40-57). Of the 88 patients who thawed/warmed oocytes, the mean age at the time of thaw/warming was 43.9 years (range, 38-50) with a mean of 5.9 years frozen (range, 1-12). Nine patients (10.2%) thawed/warmed for secondary infertility. A total of 62.5% of patients created embryos with a partner, and 37.5% used donor sperm. On average, 14.3 oocytes were thawed/warmed per patient, with 74.2% survival (range, 0%-100%) and a mean fertilization rate of 68.8% of surviving oocytes. Of 88 patients, 39 (44.3%) planned a fresh embryo transfer (ET); 36 of 39 patients had at least 1 embryo for fresh ET, and 11 had a total of 14 infants. Forty-nine of 88 patients (55.7%) planned for preimplantation genetic testing for aneuploidy, with a mean of 4.2 embryos biopsied (range, 0-14) and a euploidy rate of 28.9%. Of the 49 patients, 17 (34.7%) had all aneuploidy or no embryos biopsied. Twenty-four patients underwent a total of 36 single euploid ET with 18 live births from 16 patients. Notably, 8 PGT-A patients had a euploid embryo but no ET, affecting the future cumulative pregnancy rate. Overall, 80 patients with thaw/warming embryos had a final outcome. Of these, 20 had nothing for ET (arrested/aneuploid), and of the 60 who had ≥1 ET, 27 had a total of 32 infants, with a live birth rate of 33.8% (27/80).Conclusion(s): We report the final outcomes of patients most likely to have returned, which is useful for patient counseling: a utilization rate of 38.1% and a no-use rate of 58.9%, similar across age groups. Further studies with larger cohorts as well as epidemiologic comparisons to patients currently cryopreserving are needed. [ABSTRACT FROM AUTHOR]

• A novel methodology to estimate solar irradiance components was developed. • Methodology is based on a low-cost all sky-imager. • Spherical aberration was corrected and a pixel-radiance model was developed. • Four weather scenarios were chosen as a testing campaign. • Sky-imager has proven to be a viable alternative for solar resource assessment. The design and location of solar energy technologies are based chiefly on the availability of solar resource. Specialized measurement equipment and solar resource assessment techniques are mandatory in order to identify appropriate locations for deploying solar systems while minimizing risk and increasing the return rate of the site. These needs have given the scientific community a motivation to design highly reliable and cost-competitive sensors. This work presents a novel methodology to estimate solar irradiance components using a low-cost sky-imager system. Captured images are processed to correct the spherical aberration of the dome and to achieve a pixel-radiance model, allowing each pixel of the image to be considered as an individual source of irradiation. The performance of the proposed model is analyzed and compared in four different weather scenarios against a secondary standard solarimetric station, obtaining a normalized mean bias error for direct normal irradiance, global horizontal irradiance and diffuse horizontal irradiance of 4.53%, −6.55% and 19.62% for a sunny day, 0.79%, −6.13% and 7.00% for a partially sunny day, 1.96%, −6.58% and −0.73% for a partially cloudy day, 100%, −10.48% and −0.65% for a cloudy day, respectively. According to the experimental results, the system stands out for its performance, easy setup, low-cost components and a robust estimation in all possible weather scenarios. [ABSTRACT FROM AUTHOR]

The performance of floating photovoltaics (FPV) was assessed by this study, a technology with rising popularity in the sustainable energy sector, by comparing its economic and environmental benefits to various types of photovoltaic technologies by utilizing Life Cycle Assessment (LCA) and Cost-Benefit Analysis. The largest impacts were shown from this LCA of a 150 MW FPV plant with a 30-year lifespan, which resulted from the roughly 73 kg of greenhouse gases and 110 m3s of water per MWh generated. Additionally, 21 reservoirs were considered in Thailand to house new FPV plants. Projected power generation scenarios varied between 0.64 GW and 13.28 GW when reservoir coverage percentages ranging from 1% to 20% were used. The Levelized Cost of Energy for several different photovoltaic systems yielded 0.24 USD per kWh for the FPV system, while the ground based polycrystalline and thin film systems were 0.43 USD and 0.54 USD per kWh, respectively. The payback period for FPV was 7.5 years, while for the polycrystalline and thin film it was 7.8 and 16.3 years. This combined with other factors made for a high return on investment for the FPV system. This study recommends a 10% coverage of 21 reservoirs throughout Thailand, allowing for potentially 6.52 GW of installed capacity, which would substantially help the country to reach their 2036 goal of having 30% of the energy mix from renewable sources. • Life Cycle Assessment was conducted of a floating solar plant in Thailand. • A 150 MW plant was found to emit 73 kg of greenhouse gases per megawatt. • The Payback Period for the floating solar plant was 7.5 years. • Thailand could install between 0.64 and 13.28 GW at 21 reservoirs. [ABSTRACT FROM AUTHOR]

Objective: To synthetize the evidence regarding the effect of constant flow insufflation of oxygen (CFIO) on the rate of return of spontaneous circulation (ROSC) and other clinical outcomes during cardiac arrest (CA).Methods: A systematic review was performed using four databases (PROSPERO: CRD42020071960). Studies reporting on adult CA patients or on animal models simulating CA and assessing the effect of CFIO on ROSC or other clinical outcomes were considered.Results: A total of 3540 citations were identified, of which 16 studies were included. Four studies (two randomized controlled trials (RCT), two cohort studies), reported on humans while 12 studies used animal models. No meta-analysis was performed due to clinical heterogeneity. There were no differences in the ROSC (18.9% vs 20.8%, p = 0.99; 27.1% vs 21.3%, p = 0.51) and sustained ROSC rates (16.1% vs 17.3%, p = 0.81; 12.5% vs 14.9%, p = 0.73) with CFIO compared to intermitant positive pressure ventilation (IPPV) in the two human RCTs. Survival to ICU discharge was similar between CFIO (2.3%) and IPPV (2.3%) in the largest RCT (p = 0.96). Human studies were at serious or high risk of bias. In animal models' studies, ROSC rates were presented in seven RCTs. CFIO was superior to IPPV in one trial, but was associated with similar ROSC rates using different ventilation strategies in the remaining six studies.Conclusions: No definitive association between CFIO and ROSC, sustained ROSC or survival compared to other ventilation strategies could be demonstrated. Future studies should assess CFIO effect on post-survival neurological functions and patient-important CA outcomes. [ABSTRACT FROM AUTHOR]

A new method of inter-stage double heat exchange is proposed, which combines compressed air energy storage with traditional coal-fired power unit. It can not only reduce the heat storage investment of compressed air energy storage system, but also broaden the peak regulation margin of coal-fired power unit, and promote the stability of power grid under high proportion of new energy access. In this paper, the characteristics of the coupling system under different working conditions of coal-fired power unit are studied, and the techno-economic calculation and analysis are carried out. The results show that the round-trip efficiency of the compressed air energy storage system coupled with the coal-fired power unit can reach more than 70% under different working conditions, and the return on investment and payback period are optimistic. Among them, the efficiency and economy of the system are the best when the coal-fired power unit is operating at 50%THA. At this time, the rate of return on investment can reach 18.44%, and the payback period is about 5.14 years. • A new method of inter-stage double heat exchange was proposed for coupling. • The thermodynamic model of the CAES system coupled with CFP unit was established. • The coupling performance and economic performance of the system were analyzed. • The round-trip efficiency of each working condition could reach more than 70%. • The payback period of each working condition was within 6 years. [ABSTRACT FROM AUTHOR]

In 2014, FERC adopted a new theory of capital markets for the purpose of setting authorized returns-on-equity: that all observed dividends and interest rates were anomalous and therefore unreliable indicators of the returns necessary for investors to hold the stocks and bonds of transmission owners. The new theory, used to justify higher authorized ROEs, rejected evidence of fundamental conditions in capital markets and explicitly adopted arguments by investor-owned utilities regarding unreliable markets. After a judicial remand, FERC abandoned the new theory, but consumers in New England and the Midwest were arbitrarily charged hundreds of millions of dollars over several years due to unjust and unreasonable rates for transmission service. [ABSTRACT FROM AUTHOR]

In the traditional portfolio models, the return rates of risky assets are usually defined as random variables or fuzzy variables. However, when some events such as financial crises or wars occur that can cause instability in financial markets, the results of these assumptions are not always satisfactory. Therefore, some scholars try to use uncertain variables to express the return rates. In this paper, a two-factor uncertain portfolio problem under optimistic value criteria is studied, where we use the optimistic value instead of expected value to describe the investment return and study the impact of economic circumstance factor and corporation's specificity factor on the return rates. Firstly, a two-factor optimistic value-variance-entropy model with background risk is constructed, in which the total investment return consists of the risky asset return and the background asset return. Then, considering the investors with two kinds of risk preferences, a three-step method is applied to convert the bi-objective optimization model. Moreover, a moment estimation method is used to process the expert-estimated data on the return rates. Finally, a numerical simulation is presented for showing the applicability of our models and solution method. • We use optimistic value to represent the return rather than expected value. • The multiple factors and background risk are considered simultaneously. • Three-step method is used to convert the model into two single-objective models. [ABSTRACT FROM AUTHOR]

Hydrogen is one of the potential candidates to replace fossil fuels to meet net zero emissions target. This study reports a detailed techno-economic and environmental assessment of hydrogen production through ammonia decomposition. The case study is based on a multiple catalytic packed bed reactor with intermediate heating system. Aspen plus® and MATLAB® were linked to evaluate economic and environmental impact of the process. The process parameter like furnace temperature, flue gas recirculation, ammonia decomposition temperature, market ammonia supply pressure, ammonia decomposition pressure, hydrogen purification unit's pressure and equivalence ratio, and economic parameters of capital expenditure (CAPEX) and operating expenditure (OPEX) were considered. The overall thermal efficiency of the developed process is found to be 79%. The levelized cost of hydrogen (LCOH) is estimated and found to be 6.05 USD/kg of H 2 based on CAPEX and OPEX. A major contribution of up to 62.2% to LCOH comes from the price of feed Ammonia. Based on 25-year plant life with 10% discounted rate the plant is economically viable, with a return on investment of 23.7%, in a payback period of 3.58 years. Global warming potential of the process is also carried out. [Display omitted] • Techno-economic and environmental assessment on ammonia decomposition was carried out. • Overall thermal efficiency of H 2 production from NH 3 decomposition process is 79%. • LCOH of H 2 production from NH 3 decomposition process is 6.05 USD/kg of H 2. • Ammonia price alone contributes up to 62.2% of LCOH. • GWP analysis of H 2 production from NH 3 decomposition process is 0.66 kg of CO 2 /kg of H 2. [ABSTRACT FROM AUTHOR]

To study how proline residues affect the dynamics of Ω-loop D (residues 70 to 85) of cytochrome c , we prepared G83P and G83A variants of yeast iso-1-cytochrome c (iso-1-Cyt c) in the presence and absence of a K73H mutation. Ω-loop D is important in controlling both the electron transfer function of Cyt c and the peroxidase activity of Cyt c used in apoptosis because it provides the Met80 heme ligand. The G83P and G83A mutations have no effect on the global stability of iso-1-Cyt c in presence or absence of the K73H mutation. However, both mutations destabilize the His73-mediated alkaline conformer relative to the native state. pH jump stopped-flow experiments show that the dynamics of the His73-mediated alkaline transition are significantly enhanced by the G83P mutation. Gated electron transfer studies show that the enhanced dynamics result from an increased rate of return to the native state, whereas the rate of loss of Met80 ligation is unchanged by the G83P mutation. Thus, the G83P substitution does not stiffen the conformation of the native state. Because bis-His heme ligation occurs when Cyt c binds to cardiolipin-containing membranes, we studied the effect of His73 ligation on the peroxidase activity of Cyt c , which acts as an early signal in apoptosis by causing oxygenation of cardiolipin. We find that the His73 alkaline conformer suppresses the peroxidase activity of Cyt c. Thus, the bis-His ligated state of Cyt c formed upon binding to cardiolipin is a negative effector for the peroxidase activity of Cyt c early in apoptosis. To stiffen Ω-loop D of yeast iso-1-cytochrome c , a G83P mutation was made in the presence of a K73H mutation. Pro83 increases Ω-loop D dynamics by stabilizing the native state and the transition state relative to the His73 alkaline conformer. However, His73 ligation inhibits the peroxidase activity of iso-1-cytochrome c. [Display omitted] • G83P and G83A variants of yeast iso-1-cytochrome c were made in Ω-loop D. • A K73H mutation was also made to probe Ω-loop D dynamics. • Pro83 increases Ω-loop D dynamics as monitored by alkaline transition kinetics. • Despite increased Ω-loop D dynamics, His 73 ligation inhibits peroxidase activity. • Increased chain stiffness is not a factor in how Pro83 affects Ω-loop D dynamics. [ABSTRACT FROM AUTHOR]

Waiting for elective procedures has become a major health concern in both rich and poor countries. The inadequate balance between the demand for and the supply of health services negatively affects the quality of life, mortality, and government appraisal. This study presents the first mathematical framework shedding light on how much, when, and where to invest in health capacity to end waiting lists for elective surgeries. We model the healthcare system as a two-stage stochastic capacity expansion problem where government investment decisions are represented as a non-symmetric Nash bargaining solution. In particular, the model assesses the capacity requirements, optimal allocation, and corresponding financial investment per hospital, region, specialty, and year. We use the proposed approach to target Chile's elective surgical waiting lists (2021–2031), considering patients' priorities, 10 regional health services, 24 hospitals, and 10 surgical specialties. We generate uncertain future demand scenarios using historical data (2012–2021) and 100 autoregressive integrated moving average prediction models. The results indicate that USD 3,331.677 million is necessary to end the waiting lists by 2031 and that the Nash approach provides a fair resource distribution with a 6% efficiency loss. Additionally, a smaller budget (USD 2,000 million) was identified as necessary to end the waiting lists in a longer planning horizon. Further analysis revealed the impact of investment in patient transfer and a decline in investment yield. • We study the crisis of specialized surgical waiting lists for the next ten years. • We develop a stochastic game framework to estimate healthcare capacity investment needs. • We show that minimizing total waiting lists does not provide a fair distribution of resources. • Our model answers the questions of how much, when, and where to invest. • Capacity investment yield declines after a threshold due to demand not being monotonic. [ABSTRACT FROM AUTHOR]

Presenting to the fracture clinic carries economic, social and societal consequences. The virtual fracture clinic (VFC) has proven to be a safe, patient-focused, cost-effective means of delivering trauma care, whilst reducing unnecessary clinic attendances. Within our institution, a Satellite VFC was established, so as to accommodate an offsite referring emergency department. The VFC database was accessed to identify the first 500 patients who were referred to the Satellite VFC. The decision made for each patient, the rate of returns to the clinic, and the rate of referrals requiring surgical intervention, following discussion at the VFC, ,were identified. A cost analysis and cost comparison was carried out between the Satellite VFC and the traditional "face to face" fracture clinic. There were 500 patients referred to the Satellite VFC within the study period. Of such patients, 288 (58%) were discharged directly following review at the Satellite VFC, 141 patients (28%) were referred to physiotherapy, 50 (10%) were redirected to the trauma clinic, 11 (2%) were sent directly to hand therapy, and 10 (2%) were sent to the ED review clinic. Patients who returned to the fracture clinic accounted for 3.8% of all referrals, and 0.2% of all referrals necessitated surgical intervention. This pilot initiative saved the Dublin Midlands Hospital Group over €50,000. The Satellite VFC is the first of its kind in the literature. Rural communities worldwide would benefit from remote orthopaedic management of suitable fracture patterns. The true value of the Satellite VFC process comes from its use of robust patient care pathways, rationalising resource use and minimising patient travel, whilst demonstrating reliable outcomes and promoting safety. [ABSTRACT FROM AUTHOR]

Early adversity influences brain development and emerging behavioral phenotypes relevant for psychiatric disorders. Understanding the effects of adversity before and after conception on brain development has implications for contextualizing current public health crises and pervasive health inequities. The use of functional magnetic resonance imaging (fMRI) to study the brain at rest has shifted understanding of brain functioning and organization in the earliest periods of life. Here we review applications of this technique to examine effects of early life stress (ELS) on neurodevelopment in infancy, and highlight targets for future research. Building on the foundation of existing work in this area will require tackling significant challenges, including greater inclusion of often marginalized segments of society, and conducting larger, properly powered studies. The use of resting state functional connectivity MRI has contributed substantially to understanding of human brain functioning and organization, and revealed emerging large scale brain systems already in early infancy. Recent research shows how early brain system development varies in relation to multiple sources of pre- and postnatal adversity and biological stress mediators. Variability in early developing brain systems has implications for later emerging behaviors relevant for psychiatric disorders. Recent methodological advances promise increased precision in examining individual differences in early emerging functional brain systems. There is need for research examining mechanistic pathways for combined and interactive effects of multiple sources of early adversity on developing brain systems. This line of study is crucial for applying research findings to infants at highest risk of subsequent poor health outcomes. Greater inclusion of individuals facing the highest levels of early adversity in developmental neuroimaging work represents a priority for future research, which will require significant investment and yield critical information to address public health challenges. [ABSTRACT FROM AUTHOR]

Many solar tracking technologies have been developed with the aim of improving the energy performance of solar PV installations. Among these, single-axis tracking (SAT) systems give good economic prospect for ground-mounted PV plants but experience inevitable power loss when the trackers diverge from the incident solar irradiance during winter. The 1.5-axis tracking (1.5AT) model is developed in recent years to achieve a balance between the benefits and shortcomings of the SAT and dual-axis tracking (DAT) systems. Despite the anticipated superiority of the 1.5AT, there is a lack of literature on the methodology to analytically study the potential and feasibility of the 1.5AT model, especially from a global perspective. In this paper, a comprehensive feasibility study has been conducted to evaluate the energy performance and shading analysis of the 1.5AT model. The developed methodology serves as a general benchmark to explore the prospects of the 1.5AT model at different geographical locations and seasons. This encourages further research and deployment of the 1.5AT model as a potential alternative to improve the return of investment for various PV system stakeholders. [ABSTRACT FROM AUTHOR]

Analyzing the financial benefit of marketing is still a critical topic for both practitioners and researchers. Companies consider marketing costs as a type of investment and expect this investment to be returned to the company in the form of profit. On the other hand, companies adopt different innovative strategies to increase their value. Therefore, this study aims to test the impact of marketing investment on firm value and systematic risk. To do so, data related to four Arabic emerging markets during the period 2010-2019 are considered, and firm share price and beta share are considered to measure firm value and systematic risk, respectively. Since a firm's ownership concentration is a determinant factor in firm value and systematic risk, this variable is considered a moderated variable in the relationship between marketing investment and firm value and systematic risk. The findings of the study, using panel data regression, indicate that increasing investment in marketing has a positive effect on the firm value valuation model. It is also found that the ownership concentration variable has a reinforcing role in the relationship between marketing investment and firm value. It is also disclosed that it moderates the systematic risk aligned with the monitoring impact of controlling shareholders. This study provides a logical combination of governance-marketing dimensions to interpret performance indicators in the capital market. [ABSTRACT FROM AUTHOR]

In 2010–2011, University of Colorado (CU) librarians implemented a multi-campus pilot study to measure the institutional value of library resources used by faculty in their research. The study incorporated quantitative methods including return on investment (ROI), cost benefit analysis (CBA), and citation analysis of journal articles published by faculty; and qualitative methodologies such as in-person interviews with faculty. The study resulted in a CU ROI model that can be used to measure faculty perceptions of value and the economic benefits of electronic journal collections for faculty research in terms of ROI. The CU ROI methodology provides outcomes beyond a single ROI number and led to unexpected benefits for informing collection development decisions and strategies. [Copyright &y& Elsevier]

We study return rates on art investment using a complete dataset on repeated sales for Old Master Paintings, Modern art and Contemporary art auctioned worldwide at Christie's and Sotheby's from 2000 to 2018. We show that return rates do not depend systematically on past prices or the place of sale, but we emphasize substantial differences in returns across sectors. We also control for changes in transaction costs (buyers' premiums and artists' resale rights), characteristics of the sale (evening sales, price guarantees and past bought-ins) and news on the lots (changed attributions, public exhibitions or death of the author) that appear reflected in art returns. We confirm the absence of masterpiece effects in American, Chinese and Ethnic art. Finally, using historical data on prices during Renaissance, Baroque and Neoclassical periods, we find evidence that price changes are independent from initial prices also in the long run. [ABSTRACT FROM AUTHOR]

• A PV/T system is analyzed in 5 cities with different climate and energy costs. • The cost of energy is the most important aspect in the economic feasibility. • This work facilitates decision-making of where PV/T systems would be installed. • Returns on investment between 2-4.5 years are achieved only with financial subsidy. This paper presents the techno-economic study of a hybrid PV/T system for the simultaneous production of electric and thermal energy under different climate scenarios and energy tariffs. A simulator was developed and validated using TRNSYS software to perform a comparative energy study of five cities with different weather conditions and energy prices: Mexicali, Soria, Bigene, Fresno and Madison. Our work proposes an extended analysis with sites that have not been studied before, and complements the scope of previous work. Under same requirements of thermal energy for DHW demand, energy production was analyzed during an entire year of operation, using different numbers of PV/T modules. Results show that the city of Mexicali is the place where most energy, both thermal and electrical, is produced. In this same locality a solar thermal fraction of 80% can be reached with only three modules installed. Energy feasibility contrasts drastically with economic benefit, where Soria presents the most attractive investment returns and monetary savings of the scenarios analyzed. Moreover, a comparison of investment returns is presented, considering subsidies in the initial investment, where return of up to 1.8 years result with a 75% subsidy. In addition, a relation of the climatic conditions of the studied cities is presented, such as solar radiation and ambient temperature, in the performance of the PV/T technologies. The conclusions of the study help decision making and planning of financial support programs, since it was considered extreme climates and representative of most of the sites where PV/T systems would be installed. [ABSTRACT FROM AUTHOR]

Background: Fractures of the posterior process of the talus are rare and frequently overlooked, possibly leading to pseudo-arthrosis and chronic pain. To gain more insight into the diagnosis, treatment and outcome of fractures of the posterior process of the talus (PPTF), a systematic review of the current literature was performed to provide recommendations for the management of PPTF.Methods: A literature search in the electronic databases of PubMed, EMbase, Google Scholar and Cochrane library was performed in January 2020 to identify all clinical studies on PPTF with more than three patients. Amongst other variables, the type of study, number of patients, mechanism of injury, type of fracture (anatomy), imaging modality, treatment, postoperative protocol, outcomes, complications and duration of follow-up were noted for systematic analysis of the available evidence, adherent to the PRISMA guidelines.Results: Seven original studies were included with a total of 66 patients. More than one third of patients presented with a (sub)talar joint dislocation (n = 25, 37.9%) and 51.5% sustained associated ipsilateral lower extremity fractures (n = 34). Delayed diagnosis occurred in 36.4% of patients (n = 24). Out of 48 patients with outcome data available, 41.7% (n = 20) reported impaired function. In the non-operative group, 64.7% (n = 11) had impaired functional outcome, compared to 33.3% (n = 6) in the ORIF group, and 30.8% (n = 4) in the fragment excision group (p < 0.001). One third of the patients developed one or more complications (n = 25, 37.9%), mostly found in the non-operatively treated group (73.7%, n = 14) compared to ORIF (25.0%, n = 8, p < 0.001).Conclusion: Early recognition and timely treatment is warranted in order to achieve pre-injury functional outcome and reduce morbidity. Given the significantly higher complication rate and lower return to the previous level of functionality reported after non-operative treatment, ORIF is recommended if there is (even minimal) displacement, articular involvement or if the fracture extends into the talus body. [ABSTRACT FROM AUTHOR]

Residential battery energy storage system (BESS) adoption is hindered with its expensive price in current market. Optimally sized BESS can excel the fiscal benefits and thus can be economically sensible. An optimization problem, which targets to minimize the total annual cost including both energy and battery degradation-based costs, is formulated to investigate the added benefits of operational optimization of a BESS over the baseline operation of BESS based on self-consumption maximization (SCM). A case study is conducted considering a Victorian electricity customer in Australia. Results revealed that installation of residential BESSs are fiscally beneficial at current market prices only if adequate rebates are available. A fiscally beneficial upper limit of BESS capacity that can be installed with the prevailing government incentives depending on the PV system capacity is also found. For a given installed cost of BESS (AU$/kWh), optimal BESS capacity is larger when operational optimization of BESS is considered. However, with a time-of-use (TOU) tariff scheme, BESSs based on operational optimization outperforms BESSs based on SCM in terms of the minimum total annual cost, return on investment and PV curtailment avoidance which excels the fiscal benefits of a BESS and results in indirect greenhouse gas emission reduction. • Operational optimization of energy storage increases the return on investment. • It also reduces PV curtailment and greenhouse gas emission. • Results are compared with an energy storage based on self-consumption maximization. • A Victorian electricity customer in Australia is taken as the case study. • Battery energy storages are economically sensible with prevailing government rebates. [ABSTRACT FROM AUTHOR]

This research provides novel results and contributes to the existing literature by: (1) introducing into the analysis new variables that link the type of renewable resource (solar, wind) with financial performance; (2) studying private and public firms whose main activity is only renewable power production; (3) analyzing a large group of emerging markets, and (4) providing an overall comparison of the financial performance of fossil fuel-based vs. renewable energy-based power producers. We acquired a large longitudinal dataset describing only renewable energy companies from 16 emerging markets in the period from 2000 to 2017. The study provides comprehensive results from a variety of panel regressions that explain the return on assets (ROA) and return on equity (ROE). The results regarding the type of renewable resource indicate that ROA is higher by 0.09 for solar power producers. The legal form of the company (private vs. public) does not impact ROA but indicates that ROE is lower by 0.09 for public companies. The results are mostly similar regarding the return on equity. The results indicate that the new variables introduced into the investigation are relevant in determining the financial performance of sustainable power producers. • Different from previous studies – using data only from clean power producers. • Adding novel variables omitted in other studies: solar/wind, private/public dummies. • Solar power positively impacts performance: ROE is higher by 0.18 and ROA by 0.09 • Being a public vs. private clean energy producer decreases ROE by 0.09 • Sustainable power producers become more profitable than fossil fuel-based ones. [ABSTRACT FROM AUTHOR]