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BACKGROUND: The United States has been grappling with the opioid epidemic, which has resulted in over 75,000 opioid-related deaths between April 2020 and 2021. Evidence-based pharmaceutical interventions (buprenorphine, methadone, and naltrexone) are available to reduce opioid-related overdoses and deaths. However, adoption of these medications for opioid use disorder has been stifled due to individual- and system-level barriers. External facilitation is an evidence-based implementation intervention that has been used to increase access to medication for opioid use disorder (MOUD), but the implementation costs of external facilitation have not been assessed. We sought to measure the facility-level direct costs of implementing an external facilitation intervention for MOUD to provide decision makers with estimates of the resources needed to implement this evidence-based program. METHODS: We performed a cost analysis of the pre-implementation and implementation phases, including an itemization of external facilitation team and local site labor costs. We used labor estimates from the Bureau of Labor and Statistics, and sensitivity analyses were performed using labor estimates from the Veterans Health Administration (VHA) Financial Management System general ledger data. RESULTS: The average total costs for implementing an external facilitation intervention for MOUD per site was $18,847 (SD 6717) and ranged between $11,320 and $31,592. This translates to approximately $48 per patient with OUD. Sites with more encounters and participants with higher salaries in attendance had higher costs. This was driven mostly by the labor involved in planning and implementation activities. The average total cost of the pre-implementation and implementation activities were $1031 and $17,816 per site, respectively. In the sensitivity analysis, costs for VHA were higher than BLS estimates likely due to higher wages. CONCLUSIONS: Implementing external facilitation to increase MOUD prescribing may be affordable depending on the payers budget constraints. Our study reported that there were variations in the time invested at each phase of implementation and the number and type of participants involved with implementing an external facilitation intervention. Participant composition played an important role in total implementation costs, and decision makers will need to identify the most efficient and optimal number of stakeholders to involve in their implementation plans.

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Broiler farming is a significant source of gaseous emissions. The aim of this study was to assess the effects of different litter additives on the emission of NH3, N2O, CO2, and CH4 during broiler housing and subsequent manure storage. The gaseous emissions from the housing facilities were evaluated during one fattening cycle in environmentally controlled rooms with three different additives applied to the litter material (10% w/w aluminum sulphate or biochar and 2.50 mg m−2 urease inhibitor), as well as a control. A storage experiment was conducted under laboratory conditions for 90 days to evaluate the influence of these three additives on gaseous losses. During broiler housing, the results indicated that NH3 emissions were reduced significantly (40–60%) by litter additives, while global warming potential (GWP) emissions were reduced significantly (31%) by Alum. The addition of Biochar (a 58% reduction) had the same significant effect as Alum (a 60% reduction) to mitigate these losses. The re-application of Urease (a 41% reduction) may be required to reach an equal or higher reduction. During storage, NH3 and GWP emissions were not significantly affected by the litter additives. During broiler housing and subsequent manure storage, NH3 emissions were reduced significantly (22–41%) by litter additives, whereas GWP emissions did not decrease significantly. Globally, it can be concluded that Biochar appears to be a good alternative to Alum due to its equal effectiveness in mitigating NH3 losses, without increasing the GWP potential in the housing and avoiding pollution swapping. [ABSTRACT FROM AUTHOR]

The innovative performance of manufacturing and service companies can be impacted by the existing relationship between open innovation (OI) and the generation of confidentiality agreements (NDAs) as a tool for the protection of intellectual property. Based on the analysis of a cross-sectional sample of 6,798 industrial companies (2019–2020) and 9,304 companies in the service sector (2017–2019) that are part of the directory of the National Administrative Department of Statistics (DANE) in its Technological Innovation and Development Survey (EDIT and EDITS), it can be suggested that the interaction of these two variables (OI and NDAs) generate positive effects for the manufacturing industry but negative ones for the service sector. It could be deduced that the positive effect is due to the greater tradition of OI in the manufacturing industry and the negative effect to the caution that the service sector presents when collaborating with external actors. [ABSTRACT FROM AUTHOR]

This study examined the implementation of rate-splitting multiple access (RSMA) in a multiple-input single-output system using simultaneous wireless information and power transfer (SWIPT) technology. The coexistence of a base station and a power beacon was considered, aiming to transmit information and energy to two sets of users. One set comprises users who solely harvest energy, whereas the other can decode information and energy using a power-splitting (PS) structure. The main objective of this optimization was to minimize the total transmit power of the system while satisfying the rate requirements for PS users and ensuring minimum energy harvesting (EH) for both PS and EH users. The non-convex problem was addressed by dividing it into two subproblems. The first subproblem was solved using a deep learning-based scheme, combining principal component analysis and a deep neural network. The semidefinite relaxation method was used to solve the second subproblem. The proposed method offers lower computational complexity compared to traditional iterative-based approaches. The simulation results demonstrate the superior performance of the proposed scheme compared to traditional methods such as non-orthogonal multiple access and space-division multiple access. Furthermore, the ability of the proposed method to generalize was validated by assessing its effectiveness across several challenging scenarios. [ABSTRACT FROM AUTHOR]