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An unsupervised computational protocol is proposed with the aim of obtaining accurate structures of large molecules in the gas phase at the cost of standard density functional theory (DFT) computations. The whole workflow is fully automated and provides optimized equilibrium geometries and ground state rotational constants to be directly compared with experiments. The results for a panel of molecules of biological or medicinal interest show that the accuracy of the results delivered by the new tool at the cost of a single DFT geometry optimization is close to that delivered by state-of-the-art composite wavefunction methods for small semi-rigid molecules. [ABSTRACT FROM AUTHOR]

The shuttle-based storage/retrieval system (SBS/RS) is a new type of automatic warehouse system. More and more enterprises choose it because of its dense storage structure, small footprint, high efficiency, and many other advantages. Each enterprise has different requirements for system efficiency, the number of storage units, and the size of the warehouse. It makes sense to study the design of the minimum cost Shuttle-Based Storage/Retrieval System under the limitation of warehouse space size to meet enterprise requirements on the number of cargos and enterprise needs on system efficiency. An optimization model to minimize the system cost is established, and a heuristic algorithm is designed in this paper. Through the experiment, we identified that different system selection schemes and the configuration of facilities in the system under different throughput capacity requirements. The relationship between the system's total cost, unit cost, and design scheme of the system is found. This study can guide designers and planners to design a more reasonable system. Under the different needs of enterprises, build a Shuttle-Based Storage/Retrieval System with the lowest cost. [ABSTRACT FROM AUTHOR]

This study presents a multi-objective solving indicator-based evolutionary algorithm (IBEA) to solve the optimal power flow (OPF) problem with multiple and competing objectives. The objective functions for the multi-objective OPF (MOOPF) are active power loss, aggregate voltage deviation, total generation cost, and emission pollution. This algorithm combines the shift-based density estimation method with a weighted sum approach to produce a set of non-dominated solutions on each objective space. Moreover, an S-shaped fuzzy membership approach is used to extract the best compromise solution from the obtained non-dominated solutions. To validate the IBEA's performance, standard IEEE 30-bus and IEEE 57-bus test systems with nine different cases are being used. This paper also presents a stochastic optimal power flow problem for two-objective optimization with load demand and wind power uncertainty. [ABSTRACT FROM AUTHOR]

The Intercollegiate Membership of the Royal College of Surgeons (MRCS) examination is a mandatory requirement for higher specialty surgical training in the UK. However, there is a significant economic impact on trainees which raises the question of whether the costs of this exam hinder surgical career progression. This study explores the burden of these exams on trainees. A 37-point questionnaire was distributed to all trainees who were preparing for or have sat MRCS examinations. Univariate analyses included the cost of the preparatory resources, extra hours worked to pay for these and the examinations, and the number of annual leave (AL) days taken to prepare. Pearson correlation coefficients were used to identify possible correlation between monetary expenditure and success rate. On average, trainees (n ​= ​145) spent £332.54, worked 31.2 ​h in addition to their rostered hours, and used 5.8 AL days to prepare for MRCS Part A. For MRCS Part B/ENT, trainees spent on average £682.92, worked 41.7 extra hours, and used 5 AL days. Overall, the average trainee spent 5–9% of their salary and one-fifth of their AL allowance to prepare for the exams. There was a positive correlation between number of attempts and monetary expenditure on Part A preparation (r(109)=0.536, p ​< ​0.001). There is a considerable financial and social toll of the MRCS examination on trainees. Reducing this is crucial to tackle workforce challenges that include trainee retention and burnout. Further studies exploring study habits can help reform study budget policies to ease this pressure on trainees. • Little is known around the 'hidden' extra costs of sitting the MRCS examinations • Trainees sacrifice significant amounts in preparation, financially and socially • These expenditures likely impact trainees' job satisfaction and cause burnout • More can be done to support trainees' success at these vital exams [ABSTRACT FROM AUTHOR]

Introduction: Myopia and its vision-threatening complications present a significant public health problem. This review aims to provide an updated overview of the multitude of known and emerging interventions to control myopia, including their potential effect, safety, and costs. Methods: A systematic literature search of three databases was conducted. Interventions were grouped into four categories: environmental/behavioral (outdoor time, near work), pharmacological (e.g., atropine), optical interventions (spectacles and contact lenses), and novel approaches such as red-light (RLRL) therapies. Review articles and original articles on randomized controlled trials (RCT) were selected. Results: From the initial 3224 retrieved records, 18 reviews and 41 original articles reporting results from RCTs were included. While there is more evidence supporting the efficacy of low-dose atropine and certain myopia-controlling contact lenses in slowing myopia progression, the evidence about the efficacy of the newer interventions, such as spectacle lenses (e.g., defocus incorporated multiple segments and highly aspheric lenslets) is more limited. Behavioral interventions, i.e., increased outdoor time, seem effective for preventing the onset of myopia if implemented successfully in schools and homes. While environmental interventions and spectacles are regarded as generally safe, pharmacological interventions, contact lenses, and RLRL may be associated with adverse effects. All interventions, except for behavioral change, are tied to moderate to high expenditures. Conclusion: Our review suggests that myopia control interventions are recommended and prescribed on the basis of accessibility and clinical practice patterns, which vary widely around the world. Clinical trials indicate short- to medium-term efficacy in reducing myopia progression for various interventions, but none have demonstrated long-term effectiveness in preventing high myopia and potential complications in adulthood. There is an unmet need for a unified consensus for strategies that balance risk and effectiveness for these methods for personalized myopia management. [ABSTRACT FROM AUTHOR]

For local governments, inter-municipal cooperation (IMC) has become an increasingly common solution to tackle fiscal constraints and demographic challenges. However, in many policy areas, it is still not clear whether IMC fulfills its promises of cost savings or increased service quality. This study aims to contribute new knowledge on the effects of IMC in one of these understudied policy areas – education – and does so by employing recent developments in difference-in-differences methods. The results show that being part of IMC significantly reduces expenditures on upper secondary education. However, there are indications that decreased costs come at a price, since joining a local federation also correlates with lower grades in the cooperating municipalities. [ABSTRACT FROM AUTHOR]

Background: Bundled Payment (BP) models are becoming more common in surgery. We share our early experiences with Bundled Payments for Care Improvement for major bowel surgery. Methods: Patients undergoing major bowel surgery between January and October 2021 were identified using Medicare Severity-Diagnosis Related Group (MS-DRG) codes. Major drivers of cost in a BP model are reported and compared to the Fee-For-Service (FFS) payment model. Results: A total of 202 cases (173 FFS vs 29 BP) were analyzed. The mean BP cost per Clinical Episode was $28,340. Eleven patients (38%) in the BP model had costs greater than the Target Price. The drivers of cost in the BP model were 59% acute care facility, 17% physician services, 9% post-acute care facilities, 8% other, and 7% readmissions. Clinical Episode of care costs varied considerably by MS-DRG case complexity. Robotic surgery increased costs by 35% (mean increase $3724, P <.01). The 90-day readmission rate was 17% for a mean cost of $11,332 per readmission. Three patients (10%) were discharged to a skilled nursing facility at an average cost of $11,009, while fifteen patients (52%) received home health services at a mean cost of $2947. Acute care facility costs were similar in the BP vs FFS groups (mean difference $1333, P =.22). Conclusions: Patients undergoing major bowel surgery are a heterogeneous population. Physicians are ideally positioned to deliver high-value, patient-centered care and are crucial to the success of a BP model. The post-acute care setting is a key component of improving efficiency and quality of care. [ABSTRACT FROM AUTHOR]

We begin by showing that every theory of the value of uncertain prospects must have one of three unpalatable properties. Reckless theories recommend giving up a sure thing, no matter how good, for an arbitrarily tiny chance of enormous gain; timid theories permit passing up an arbitrarily large potential gain to prevent a tiny increase in risk; non‐transitive theories deny the principle that, if A$A$ is better than B$B$ and B$B$ is better than C$C$, then A$A$ must be better than C$C$. Having set up this trilemma, we study its horns. Non‐transitivity has been much discussed; we focus on drawing out the costs and benefits of recklessness and timidity when it comes to axiology, decision theory, and normative uncertainty. [ABSTRACT FROM AUTHOR]

Agroecological farming emerges among approaches for managing crop pests including the “True” fruit fly (Diptera, Tephritidae). We conducted baseline interviews and field experiments in Eastern Central Tanzania to determine farmers’ perception on the approach and verify its socio-economic performance in cucurbit crop production. The performance of small-scale cucurbit farming in agroecological and conventional agriculture was broadly comparable. Farmers perceived the approach as effective and beneficial over conventional farming and pesticide-based agriculture but constrained by its more elaborate/laborious implementation. Still, agroecological farming significantly lowered the production costs. Therefore small-scale agroecological cucurbit farming in Tanzania represents a viable alternative and promising tool to reduce use of synthetic pesticides that negatively impact human health and the environment. [ABSTRACT FROM AUTHOR]

A robust two-stage problem of selecting a single minimum cost representative out of n candidates is studied. Each candidate is associated with an uncertain cost that is described by a lower bound and a deviation from it. In the first stage, at most k representatives have to be selected. After that, an adversary distributes the worst costs to all representatives so that the sum of the cost deviation ratios (the uncertainty budget) does not exceed a given upper bound. In the second stage, the cost of the cheapest representative is paid. An O (n 2 log n) time algorithm is proposed for this problem. [ABSTRACT FROM AUTHOR]

PurposeMethodsResultsConclusionsTo evaluate the incidence and cost of intraocular lens(IOL) waste during IOL implantation, as well as the reasons for it.A retrospective analysis was conducted on the data of 485 patients from the IOL waste registers of a single tertiary eye hospital in China during 2016–2020. The primary outcomes were the incidence, cost, and reasons for different IOL properties. Cases were examined to ascertain IOL material, design, procedural details, and causes of waste.IOL waste occurred in 485 (6.62‰) of the 73,246 IOL implantations during the study period. The total cost of IOL waste was 429, 850.26 Chinese Yuan (CNY) related to waste with an average cost of 2, 442.33 CNY per procedure during the study period. Comparisons between IOL properties showed that polymethyl methacrylate (PMMA) material (39, 2.05%), three-piece design (142, 1.49%), and secondary IOL implantation (26, 2.16%) were associated with IOL wastage, and the difference was statistically significant. The causes of IOL waste were damage (107, 60.80%), patient reasons (37, 21.26%), aseptic errors (22, 12.50%), IOL quality problems (8, 4.55%), and loss (2, 1.14%).The incidence of IOL waste is low, but still leads to a significant cost burden due to a large number of cataract surgeries. PMMA material, three-piece design, and secondary implantation were identified as factors increasing IOL waste. Damage emerged as the primary reason for waste, largely attributed to human error. Therefore, the development of strategies to mitigate IOL waste is imperative. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion To evaluate an ‘On‐Demand’ snack service in a rehabilitation setting for satisfaction, intake, waste and cost.In September 2021, a trial of an ‘On‐Demand’ snack service was conducted on two general rehabilitation wards in a purpose‐built rehabilitation hospital. A retrospective comparison of pre‐implementation, 1‐month and 8‐month post‐implementation audit data was used to evaluate staff and patient satisfaction, nutritional intake, waste and cost (labour and food). Descriptive and inferential statistical analyses were performed for intake quantitative data and content analysis was conducted for qualitative data.A total of 26 responses from staff and 34 from patients were received. Staff reported higher overall satisfaction with the ‘tea‐trolley’ service (50% vs. 32%; χ2 6.815 [2]; p < 0.05). Patient satisfaction ratings of the original ‘tea‐trolley’ system were higher than the ‘On‐Demand’ snacks system (96% vs. 59%; χ2 41.60 [2]; p < 0.0001). Median daily intake from snack food and drinks was maintained (938 kJ and 6 g protein vs. 925 kJ and 6 g protein) and waste (23.3% vs. 20.9%; p < 0.05) decreased with the ‘On‐Demand’ service. Cost of ordered food was similar ($778.15 ‘tea‐trolley’ vs. $746.1 ‘On‐Demand’), however cost of waste ($179.47 ‘tea‐trolley’ vs. $128.7 ‘On‐Demand’) and labour ($1650.46 ‘tea‐trolley’ vs. $926.44 ‘On‐Demand’) reduced by 28% and 44%, respectively, with the ‘On‐Demand’ snack service.Implementing an ‘On‐Demand’ snack service in the general inpatient rehabilitation setting resulted in reductions in food waste, foodservice staff labour and waste costs, while intake was maintained. Patient and staff satisfaction decreased warranting further investigation into appropriate implementation methods. [ABSTRACT FROM AUTHOR]

Aim: Musculoskeletal conditions constitute a remarkable portion of disability cases in the military. This study evaluated the distribution and types of musculoskeletal problems and estimated the direct and indirect costs due to these complaints in an Iranian military hospital. Methods: All medical records of patients with musculoskeletal complaints that were referred to the medical committee of a military hospital, including rheumatology, orthopedics, and neuro-surgical specialists, from 2014 to 2016, were reviewed. Details of each complaint and the final opinion of the medical committees were recorded. The cost of each diagnostic step was calculated based on the recorded data. The treatment costs were estimated for each complaint by calculating the average cost of treatment plans suggested by two specialists, a physical medicine and a rheumatologist. The estimated cost for each part is calculated based on the army insurance low. Indirect costs due to absences, inability to work, and disability were assessed and added to the above-mentioned direct costs. Statistical analysis was performed using SPSS version 21. Results: 2,116 medical records of the committee were reviewed. 1252 (59.16%) cases were soldiers (who had to spend two years of mandatory duty in the army), and 864 (40.83%) cases were non-soldiers. The three most common complaints were fractures (301 cases, 14.22%), low back pain due to lumbar disc bulges and herniations (303 cases, 14.31%), and genu varus/genu valgus (257 cases, 12.14%). The most affected sites were the lower limbs and vertebral column. According to an official document in these subjects' records, 4120 person-days absent from work were estimated annually, and nearly $1,172,149 of annual economic impact was calculated. Conclusion: Musculoskeletal problems are common in the army, and establishing preventive strategies for these conditions is essential. The conservative and medical approach and the proper education for correct movement and the situation should be mentioned for the reduction of disability and its economic burden on the army's staff. [ABSTRACT FROM AUTHOR]

Reproduction includes two energy investmentsÑthe energy in the offspring and the energy expended to make them. The former is well understood, whereas the latter is unquantified but often assumed to be small. Without understanding both investments, the true energy costs of reproduction are unknown. We present a framework for estimating the total energy costs of reproduction by combining data on the energy content of offspring (direct costs) and the metabolic load of bearing them (indirect costs). We find that direct costs typically represent the smaller fraction of the energy expended on reproduction. Mammals pay the highest reproductive costs (excluding lactation), ~90% of which are indirect. Ectotherms expend less on reproduction overall, and live-bearing ectotherms pay higher indirect costs compared with egg-layers. We show that the energy demands of reproduction exceed standard assumptions. [ABSTRACT FROM AUTHOR]

AbstractTelemedicine is an emerging option to improve patients’ medical outcomes and overcome health disparities. The technology is a cost-effective alternative to in-person medical treatments and can supplement medical care to alleviate stress on the medical infrastructure in the upcoming decade. This study uses survey methods to investigate the patient population’s intention to use telemedicine and assess the influence of different variables on telemedicine usage choices. Findings show that loss of income, trust in physicians, and time lost reduce intention to use telemedicine. The results carry implications for the healthcare industry, lawmakers, social workers, community activists, and family caregivers who bear the burden of helping loved ones with everyday tasks. [ABSTRACT FROM AUTHOR]

Road traffic injuries cause considerable financial strain on health care systems worldwide. We retrospectively analyzed injury-related costs of 252 severely injured (New Injury Severity Score, NISS ≥ 16) patients treated at Tampere University Hospital (TAUH) between 2013 and 2017, with 2-year follow-up. The costs were divided into direct treatment, indirect costs, and other costs. We analyzed various injury- and patient-related factors with costs. The total costs during the 2-year study period were 20 million euros. Median cost was 41,202 euros (Q1 23,409 euros, Q3 97,726 euros), ranging from 2,753 euros to 549,787 euros. The majority of costs (69.1%) were direct treatment costs, followed by indirect costs (28.4%). Other costs were small (5.4%). Treatment costs increased with the severity of the injury or when the injury affected the lower extremities or the face. Indirect costs were higher in working age patients and in patients with a higher level of education. The relative proportions of direct and indirect costs were constant regardless of the amount of the total costs. The largest share of costs was caused by a relatively small proportion of high-cost patients during the 1st year after injury. Combined, this makes planning of resource use challenging and calls for further studies to further identify factors for highest costs. [ABSTRACT FROM AUTHOR]

• A new constellation lifecycle cost optimization problem was introduced. • Useful insights to the satellite burn-in problem can guide satellite manufacturers. • Long testing durations are undesirable; testing can be traded off with number of satellites produced. • Combining burn-in, warranty and availability analysis opens new paths for constellation research. Constellation lifecycle costs are an important metric for constellation designers. Recurring costs of mega constellations in particular are large relative to the non-recurring costs, yet little attention has been given to the reduction of recurring costs. Moreover, few studies exist on the impacts of pre-launch activities such as satellite testing on subsequent operational reliability. We thus study the lifecycle cost impacts of environmental stress screening during acceptance testing to minimize constellation lifecycle costs. Parallels are drawn with the field of electronics testing, and costs arising from burn-in, replacement and availability are considered in our formulation. A single-objective cost minimization problem and a multi-objective cost and unavailability minimization problem are presented to capture different mission applications that require different objectives. The effects of system homogeneity and the use of sparing strategies are investigated. We propose genetic algorithms to solve the optimization problems and give some insight into how burn-in should be carried out for minimizing total costs. The optimization is also applied to a case study of a proposed mission scenario and the constellation lifecycle costs of an optimized burn-in plan are compared to those of a typical "reliability target" burn-in plan. The optimization resulted in lifecycle cost savings of around 19% while significantly reducing the burn-in duration, showing much promise in the burn-in cost optimization approach. [ABSTRACT FROM AUTHOR]

Nowadays, most image steganographic schemes embed secret messages by minimizing a well-designed distortion cost function for the corresponding domain, i.e., the spatial domain for spatial image steganography or the JPEG (Joint Photographic Experts Group) domain for JPEG image steganography. In this paper, we break the boundary between these two types of schemes by establishing a theoretical link between the distortion costs in the spatial domain and those in the JPEG domain and thus propose a scheme for domain transformations of distortion costs for efficient JPEG steganography with symmetric embedding, which can directly convert the spatial distortion cost into its JPEG counterpart. Specifically, by formulating the distortion cost function for JPEG images in the decompressed spatial domain, a closed-form expression for a distortion cost cross-domain transformation is derived theoretically, which precisely characterizes the conversion from the distortion costs obtained by existing spatial steganographic schemes to those applied in JPEG steganography. Experimental results demonstrate that the proposed method outperforms other advanced JPEG steganographic schemes, e.g., JUNIWARD (JPEG steganography with Universal Wavelet Relative Distortion), JMiPOD (JPEG steganography by Minimizing the Power of the Optimal Detector), and DCDT (Distortion Cost Domain Transformation), in resisting the detection of various advanced steganalyzers. [ABSTRACT FROM AUTHOR]

Purpose: To remain sustainable, open source software (OSS) projects must attract new members—or newcomers—who make contributions. In this paper, the authors develop a set of hypotheses based on the knowledge barriers framework that examines how OSS communities can encourage contributions from newcomers. Design/methodology/approach: Employing longitudinal data from the source code repositories of 232 OSS projects over a two-year period, the authors employ a Poisson-based mixed model to test how community characteristics, such as the main drivers of knowledge-based costs, relate to newcomers' contributions. Findings: The results indicate that community characteristics, such as programming language choice, documentation effort and code structure instability, are the main drivers of knowledge-based contribution costs. The findings also suggest that managing these costs can result in more inclusive OSS communities, as evidenced by the number of contributing newcomers; the authors highlight the importance of maintaining documentation efforts for OSS communities. Originality/value: This paper assumes that motivational factors are a necessary but insufficient condition for newcomer participation in OSS projects and that the cost to participation should be considered. Using the knowledge barriers framework, this paper identifies the main knowledge-based costs that hinder newcomer participation. To the best of the authors' knowledge, this is the first empirical study that does not limit data collection to a single hosting platform (e.g., SourceForge), which improves the generalizability of the findings. [ABSTRACT FROM AUTHOR]

Introduction: Antimicrobial resistance (AMR) is one of the most serious public health challenges worldwide, including in Japan. However, there is limited evidence assessing the AMR burden in Japan. Thus, this systematic literature review (SLR) and meta-analysis (MA) were conducted to assess the clinical and economic burden of AMR in Japan. Methods: Comprehensive literature searches were performed on EMBASE, MEDLINE, the Cochrane Library, and ICHUSHI between 2012 and 2022 following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. MA estimated a pooled effect between the two comparative arms (AMR vs. non-AMR). The results were reported in measures of odds ratios (ORs) for in-hospital mortality and in standardized mean differences (SMDs) for length of stay (LOS) and direct medical costs. Results: Literature searches identified 1256 de-duplicated records, of which 56 observational studies (English, n = 35; Japanese, n = 21) were included. Of note, twenty-two studies (39.3%) compared the AMR group with non-AMR group. In the SLR, in-hospital mortality, LOS, and direct medical costs were higher in the AMR group compared to the non-AMR group. Eight studies were selected for the MA. In the AMR group, the pooled estimate showed a statistically higher in-hospital mortality [random effect (RE)—OR 2.25, 95% CI 1.34–3.79; I2 = 89%; τ2 = 0.2257, p < 0.01], LOS (RE—SMD 0.37, 95% CI − 0.09–0.84; I2 = 99%; τ2 = 0.3600, p < 0.01), and direct medical cost (RE—SMD 0.53, 95% CI 0.43–0.62; I2 = 0.0%; τ2 = 0.0, p = 0.88) versus the non-AMR group. Conclusion: Our study presents an overview of the clinical and economic burden of AMR in Japan. Patients with AMR infections experience significantly higher in-hospital mortality, LOS, and direct medical costs compared with patients without AMR infections. [ABSTRACT FROM AUTHOR]

While for decades behavioural ecologists have studied the costs and benefits of group living, solitary living has received little attention. Instead, it was assumed to be the default stage from which sociality evolved. Mammals underwent around 200 million years of social evolution, with a few species evolving communal or cooperative breeding in harsh environments. Other mammal species are successful with solitary living in exactly the same and many other environments, indicating that solitary living is beneficial under many environmental conditions. Comparative studies on mammals indicate that solitary living might not be the ancestral but a derived state. Solitary living in mammals is less common than previously believed, occurring in 22% of the studied species. Here, we review costs and benefits of solitary living in mammals. We found very few studies that considered solitary living and show important future avenues of research based on the factors that are important for the evolution of group living. We also emphasize that a solitary form of social organization does not imply an unsocial lifestyle: solitary mammals typically have non‐random but individualized social interactions with their neighbours, indicating important social structure. [ABSTRACT FROM AUTHOR]

We consider a model of friendship network formation based on de Marti and Zenou (2017) where individuals belong to two different communities and costs of forming links depend on community memberships. Once there are myopic and farsighted individuals in both communities, many inefficient friendship networks such as segregation, partial integration or partial assimilation become destabilized. In the case of low intra-community costs, either (for high inter-community costs) the network where the smaller community ends up being assimilated into the dominant community or (for low inter-community costs) the network where both communities are fully integrated is both stable and strongly efficient. In the case of intermediate intra-community costs, star networks with a myopic individual in the center are both stable and strongly efficient. [ABSTRACT FROM AUTHOR]

There is a need for increased renewable energy to meet net-zero targets and decarbonise the economy. Harnessing the predictable power of the tides with tidal stream turbines can contribute to this. Tidal energy is a nascent technology with higher costs at present. However, cost reductions have been observed with an increased deployment in other renewable energy technologies that have received financial support, and it is postulated that similar will happen with tidal energy. The first tidal stream projects have been awarded market support in the UK through the Contracts for Difference (CfD) scheme, with almost 100 MW expected to be commissioned by 2028. This work uses learning rates to investigate how much investment in ongoing market support might be needed to achieve cost reductions through subsidised deployment alongside research and innovation. Using a range of informed 'what if?' scenarios, it shows sensitivity to key inputs. The results show that the support needed is most sensitive to the learning rate, reducing it from 15% to 12.5% or 10% doubles or more than quadruples the investment required, respectively. The support is also highly dependent on the starting cost from which learning occurs, taken as the CfD Strike Price in 2025. Varying this between 156 and 220 GBP/MWh results in total investment of GBP 6.7 and 22.3 bn, respectively. Most importantly, a balance is needed between subsidising deployment to drive down costs through learning and funding innovation to maintain a high learning rate. [ABSTRACT FROM AUTHOR]

The pine wood nematode (PWN) uses several Monochamus species as vehicles, through a temporary hitchhiking process known as phoresy, enabling it to access new host plant resources. Monochamus saltuarius acts as a new and major vector of the PWN in Northeastern China, showing lower PWN carrying capacity and a shorter transmission cycle compared to established vectors. The apparently altered symbiotic relationship offers an interesting area for researching the costs and adaptions involved in nematode–beetle, a specialized phoresy. We analyzed the response and fitness costs of M. saltuarius through physiological measurements and transcriptomics. The PWN exerted adverse repercussions on the growth and development of M. saltuarius. The PWN accelerated larval development into pupae, while beetle adults carrying the PWN exhibited an elevated abnormality rate and mortality, and reduced starvation resistance. During the pupal stage, the expression of growth-related genes, including ecdysone-inducible genes (E74EA), cuticle proteins, and chitin genes (CHTs), markedly increased. Meanwhile, the induced immune response, mainly by the IMD and Toll signaling pathways, could be a contributing factor to adult abnormality and mortality. Adult gonads and trachea exhibited enrichment in pathways related to fatty acid elongation, biosynthesis, and metabolism. FASN, ELOVL, and SCD possibly contributed to resistance against PWN. Our research indicated that phoretic interactions between vector beetles and PWN vary throughout the vector's lifespan, particularly before and after entry into the trachea. This study highlighted the fitness costs of immunity and metabolism on the vector beetle, indicating the adaptation mechanisms and evolutionary trade-offs to PWN. [ABSTRACT FROM AUTHOR]

Spine surgeons are often unaware of drivers of cost variation for anterior cervical discectomy and fusion (ACDF). We used time-driven activity-based costing to assess the relationship between body mass index (BMI), total cost, and operating room (OR) times for ACDFs. Total cost was divided into direct and indirect costs. Individual costs were obtained by direct observation, electronic medical records, and through querying multiple departments. Timestamps for all involved personnel and material resources were documented. Total intraoperative costs were estimated for all ACDFs from 2017 to 2022. All patients were categorized into distinct BMI-based cohorts. Linear regression models were performed to assess the relationship between BMI, total cost, and OR times. A total of 959 patients underwent ACDFs between 2017 and 2022. The average age and BMI were 58.1 ± 11.2 years and 30.2 ± 6.4 kg/m2, respectively. The average total intraoperative cost per case was $7120 ± $2963. Multivariable regression analysis revealed that BMI was not significantly associated with total cost (P = 0.36), supply cost (P = 0.39), or personnel cost (P = 0.20). Higher BMI was significantly associated with increased time spent in the OR (P = 0.018); however, it was not a significant factor for the duration of surgery itself (P = 0.755). Rather, higher BMI was significantly associated with nonoperative OR time (P < 0.001). Time-driven activity-based costing is a feasible and scalable methodology for understanding the true intraoperative costs of ACDF. Although higher BMI was not associated with increased total cost, it was associated with increased preparatory time in the OR. [ABSTRACT FROM AUTHOR]

Behavioral avoidance of parasites is a widespread strategy among animal hosts and in human public health. Avoidance has repercussions for both individual and population-level infection risk. Although most cases of parasite avoidance are viewed as adaptive, there is little evidence that the basic assumptions of evolution by natural selection are met. This study addresses this gap by testing whether there is a heritable variation in parasite avoidance behavior. We quantified behavioral avoidance of the bacterial parasite Serratia marcescens for 12 strains of the nematode host Caenorhabditis elegans. We found that these strains varied in their magnitude of avoidance, and we estimated the broad-sense heritability of this behavior to be in the range of 11%–26%. We then asked whether avoidance carries a constitutive fitness cost. We did not find evidence of one. Rather, strains with higher avoidance had higher fitness, measured as population growth rate. Together, these results direct future theoretical and empirical work to identify the forces maintaining genetic variation in parasite avoidance. [ABSTRACT FROM AUTHOR]

Introduction:Teledermatology adoption continues to increase, in part, spurred by the COVID-19 pandemic. This study analyzes the utility and cost savings of a store-and-forward teledermatology consultative system within the Veterans Health Administration (VA). Methods:Retrospective cohort of 4,493 patients across 14 remote sites in Tennessee and Kentucky from May 2017 through August 2019. The study measured the agreement between the teledermatology diagnoses and follow-up face-to-face clinic evaluations as well as the cost effectiveness of the teledermatology program over the study period. Results:Fifty-four percent of patients were recommended for face-to-face appointment for biopsy or further evaluation. Most patients, 80.5% received their face-to-face care by a VA dermatologist. There was a high level of concordance between teledermatologist and clinic dermatologist for pre-malignant and malignant cutaneous conditions. Veterans were seen faster at a VA clinic compared with a community dermatology site. Image quality improved as photographers incorporated teledermatologist feedback. From a cost perspective, teledermatology saved the VA system $1,076,000 in community care costs. Discussion:Teledermatology is a useful diagnostic tool within the VA system providing Veteran care at a cost savings. [ABSTRACT FROM AUTHOR]

Introduction Methods Result Conclusion While digital breast tomosynthesis (DBT) has proven to enhance cancer detection and reduce recall rates (RR), its integration into BreastScreen Australia for screening has been limited, in part due to perceived cost implications. This study aims to assess the cost effectiveness of digital mammography (DM) compared with synthesized mammography and DBT (SM + DBT) in a first round screening context for short‐term outcomes.Clients recalled for nonspecific density (NSD) as a single lesion by both readers at the Northern Sydney Central Coast BreastScreen service in 2019 were included. Prior images were excluded to simulate first‐round screening. Eleven radiologists read DM and synthesized mammography with DBT (SM + DBT) images 4 weeks apart. Recall rates (RR), reading time, and diagnostic parameters were measured, and costs for screen reading and assessment were calculated.Among 65 clients studied, 13 were diagnosed with cancer, with concordant cancer recalls. SM + DBT reduced recall rates (RR), increased reading time, maintained cancer detection sensitivity, and significantly improved other diagnostic parameters, particularly false positive rates. Benign biopsy recalls remained equivalent. While SM + DBT screen reading cost was significantly higher than DM (DM AU$890 ± 186 vs SM + DBT AU$1279 ± 265; P < 0.001), the assessment cost (DM AU$29,504 ± 9427 vs SM + DBT AU$18,021 ± 5606; P < 0.001), and combined screen reading and assessment costs were significantly lower (DM AU$30,394 ± 9508 vs SM + DBT AU$19,300 ± 5721; P = 0.001). SM + DBT screen reading and assessment of 65 patients resulted in noteworthy cost savings (AU$11,094), equivalent to assessing 12 additional clients.In first round screening, DBT yields significant cost savings by effectively reducing unnecessary recalls to assessment while maintaining diagnostic efficacy. [ABSTRACT FROM AUTHOR]

Summary: This paper proposes a double‐node upset complete resilient (DNUCR) latch to meet the requirements of low orbit space applications for high robustness, cost‐effectiveness, and high performance. With the help of its interlocked loops with multiple feedbacks consisting of C‐elements (CE), input splitting CEs, 1P‐2N and 2P‐1N elements, and inverters, the proposed DNUCR latch preserves the original data even after the radiation incident. Error injection simulations in Synopsys HSPICE show that the proposed DNUCR latch recovers from all DNUs and can withstand large amount of injected charge. The simulation outcomes further show that the proposed DNUCR latch outperforms existing DNU‐resilient latches in terms of delay, power consumption, and power–delay–area product (PDAP), with an average of 48% reduction in delay, 22% savings in power, and 60% reduction in PDAP. The proposed DNUCR latch is also found to be the best among the existing radiation‐hardened latches in terms of charge‐to‐PDAP ratio. [ABSTRACT FROM AUTHOR]

To investigate the impact of kitchen waste compost on the formulation of rice seedling substrate, this study employed indoor seedling tray nursery methods. Six formulations, incorporating kitchen waste compost, peat, and vermiculite as raw materials, were prepared based on volume-specific gravity. The physicochemical characteristics of each seedling substrate were analyzed to assess their influence on rice seedling growth, considering the cost implications of synthesizing different formulations. The findings revealed a significant alteration in both the physicochemical parameters of the seedling substrate and the growth indexes of rice seedlings as the substitution of peat by kitchen waste compost increased. The formulation denoted as WF1 exhibited physicochemical parameters and growth indexes aligning with all applicable standards. Notably, key physicochemical indicators, including pH, electrical conductivity (EC), unit weight, and aeration porosity, increased gradually with the rising proportion of kitchen waste compost. Conversely, growth indicators such as seedling emergence rate, plant height, and stem thickness exhibited a gradual decline. The concentration of malondialdehyde (MDA) and antioxidant enzyme activities in rice seedling roots indicated that an increased presence of kitchen waste compost imposed significant stress on rice seedling growth. From a formulation cost perspective, integrating kitchen waste compost into the rice seedling substrate effectively reduced costs. The WF1 treatment demonstrated a 9.53% reduction in formulation cost compared to the CK treatment. The optimal formulation, consisting of 10% kitchen waste compost, 40% peat, and 50% vermiculite, was identified as better suited for the growth of rice seedlings, achieving a balance between growth performance and cost efficiency. In conclusion, incorporating kitchen waste compost in rice nursery substrate formulation can yield cost-effective solutions while maintaining acceptable growth parameters for rice seedlings. [ABSTRACT FROM AUTHOR]

Mind wandering, generally defined as task-unrelated thought, has been shown to constitute between 30% and 50% of individuals' thoughts during almost every activity in which they are engaged. Critically, however, previous research has shown that the demands of a given task can lead to either the up- or down-regulation of mind wandering and that engagement in mind wandering may be differentially detrimental to future memory performance depending on learning conditions. The goal of the current research was to gain a better understanding of how the circumstances surrounding a learning episode affect the frequency with which individuals engage in off-task thought, and the extent to which these differences differentially affect memory performance across different test formats. Specifically, while prior work has manipulated the conditions of encoding, we focused on the anticipated characteristics of the retrieval task, thereby examining whether the anticipation of later demands imposed by the expected test format/difficulty would influence the frequency or performance costs of mind wandering during encoding. Across three experiments, we demonstrate that the anticipation of future test demands, as modelled by expected test format/difficulty, does not affect rates of mind wandering. However, the costs associated with mind wandering do appear to scale with the difficulty of the test. These findings provide important new insights into the impact of off-task thought on future memory performance and constrain our understanding of the strategic regulation of inattention in the context of learning and memory. [ABSTRACT FROM AUTHOR]

Among all technologies applied in three-dimensional printing (3DP), fused deposition modeling (FDM) is the most developing one because it is capable of producing parts with geometrically complex figures. Despite its wide applications, there are some drawbacks to its extension, for instance, weak mechanical characteristics and low dimensional accuracy. In this paper, the influence of four FDM process parameters (layer height, printing speed, infill density, and the number of top and bottom layers) on four criteria (impact strength, dimensional accuracy, consumed raw material, and production time) of polylactic acid (PLA) parts is studied. Unlike previous research, this research not only optimizes the properties of produced parts but also minimizes production costs. First, each criterion is analyzed singly; then, in an investigation, all criteria are combined and optimized simultaneously. In other words, a comprehensive decision is made considering both products' qualities and the production costs. The applied methodology for multi-criterion decision-making in this research is also usable in other fields of industry. With the help of this methodology, the best selection of process parameters' levels is attainable. According to the results, layer height = 0.3 mm, number of top and bottom layers = 2, infill density = 60% and print speed = 45.28 mm/s are the best choice while considering all four criteria. Layer height is found the most effective parameter. An increase in layer height leads to a stronger part with a shorter production time but a heavier one with less dimensional accuracy. [ABSTRACT FROM AUTHOR]

Background and purpose: With the emergence of new treatment options for myasthenia gravis (MG), there is a need for information regarding epidemiology, healthcare utilization, and societal costs to support economic evaluation and identify eligible patients. We aimed to enhance the understanding of these factors using nationwide systematic registry data in Norway. Methods: We received comprehensive national registry data from five Norwegian health‐ and work‐related registries. The annual incidence and prevalence were estimated for the period 2013–2021 using nationwide hospital and prescription data. The direct, indirect (productivity losses) and intangible costs (value of lost life‐years [LLY] and health‐related quality of life [HRQoL]) related to MG were estimated over a period of 1 year. Results: In 2021, the incidence of MG ranged from 15 to 16 cases per year per million population depending on the registry used, while the prevalence varied between 208.9 and 210.3 per million population. The total annual societal costs of MG amounted to EUR 24,743 per patient, of which EUR 3592 (14.5%) were direct costs, EUR 8666 (35.0%) were productivity loss, and EUR 12,485 (50.5%) were lost value from LLY and reduced HRQoL. Conclusion: The incidence and prevalence of MG are higher than previously estimated, and the total societal costs of MG are substantial. Our findings demonstrate that productivity losses, and the value of LLY and HRQoL constitute a considerable proportion of the total societal costs. [ABSTRACT FROM AUTHOR]

This article reviews and critically assesses the "cost coordination" theory of harm developed in a recent eponymous article, Harrington (2022), and its application to the EU trucks case. We conclude that, while the cost coordination theory is a valuable and interesting contribution to the academic literature, it assumes a number of market features that may not be present in the EU trucks case—in particular that list price coordination is persistent rather than occasional, that transaction prices are sufficiently transparent to implement an effective monitoring and retaliation mechanism, and that list price changes are interpreted by local price setters as reflecting changes in cost rather than changes in other variables. We also note that, compared with standard price coordination, cost coordination generally tends to be both harder to sustain and less effective at raising prices if it is sustained. [ABSTRACT FROM AUTHOR]

This study aimed to examine factors, healthcare utilization, and medical costs associated with potentially inappropriate use of benzodiazepines in persons living with HIV (PLWH). We used big data from Medicare claims in 2017. Potentially inappropriate use of benzodiazepines was defined as having any benzodiazepine claims in individuals 65+ years or having benzodiazepine claims for more than four weeks in individuals 18–64 years. Logistic regressions, zero-inflated negative binomial regressions, and generalized linear models were used. This study included 1,211 PLWH and 235 (19.41%) had potentially inappropriate use of benzodiazepines. PLWH who were 65+ years (OR: 0.56; 95% CI: 0.33, 0.96), non-Hispanic blacks (OR: 0.29; 95% CI: 0.20, 0.41), or Hispanics (OR: 0.55; 95% CI: 0.35, 0.88) were less likely to use benzodiazepines inappropriately. PLWH who had potentially inappropriate use of benzodiazepines had more inpatient (IRR: 1.46; 95% CI: 1.10, 1.94), outpatient (IRR: 1.14; 95% CI 1.02, 1.28), and emergency room (IRR: 1.32; 95% CI: 1.03, 1.68) visits. Potentially inappropriate use of benzodiazepines was associated with higher total (β: 0.16; 95% CI: 0.07, 0.25), Medicare (β: 0.18; 95% CI: 0.07, 0.28), and out-of-pocket (β: 0.21; 95% CI: 0.05, 0.36) costs. This study provides real-world evidence to support deprescribing benzodiazepines in PLWH. [ABSTRACT FROM AUTHOR]

It has long been established that the presence of the so-called "Ghent systems" of unemployment insurance greatly enhances unionization rates. This paper investigates the political determinants of the choice for and against the introduction and continuation of these systems. Based on a diachronic analysis of three paradigmatic cases, Belgium, the Netherlands, and Sweden, and two shadow cases, Germany and Britain, it shows that all major actors were well aware of their organizational effect during the first half of the 20th century. At the same time, it shows that long-term strategic thinking only played a major role in shaping party attitudes toward "Ghent" in countries where the prevailing party system ensured that its introduction produced clear partisan "winners" and "losers." In all other countries, cost considerations were central in shaping party views on Ghent. The analysis shows how cost considerations can explain both bourgeois party support for its introduction and left-party support for its discontinuation. [ABSTRACT FROM AUTHOR]

Objectives: To assess whether, and to what extent, juvenile adjudications contribute to cumulative disadvantage at adult sentencing. Additionally, we parse out the relative contribution of structural disadvantage. Methods: Using data on individuals sentenced in Pennsylvania Courts of Common Pleas from 2015 to 2019, we estimate real and counterfactual incarceration sentences (probability and length). We term the difference between these estimates the "collateral cost" of juvenile adjudication. We also estimate counterfactuals under alternative policy structures. Results: Adjudications impose a substantial collateral cost on adult sentences, raising the probability of incarceration by 0.14 (23 percent of total risk) and the length of incarceration by 3 months. The cost of juvenile records is greater for individuals convicted of moderately to very serious crimes and for Black and male defendants. Structural factors are most impactful for the most common offense levels. Alternative policy structures can lessen absolute costs but are not capable of eliminating disparate costs across demographic groups. Conclusions: The use of juvenile adjudications to inform adult sentencing recommendations contributes to cumulative disadvantage, both in that Black and male defendants are more likely to be affected and that they face greater costs when they do. Guidelines changes can reduce this cost for many defendants. [ABSTRACT FROM AUTHOR]

Some aspects of cognition are more taxing than others. Accordingly, many people will avoid cognitively demanding tasks in favor of simpler alternatives. Which components of these tasks are costly, and how much, remains unknown. Here, we use a novel task design in which subjects request wages for completing cognitive tasks and a computational modeling procedure that decomposes their wages into the costs driving them. Using working memory as a test case, our approach revealed that gating new information into memory and protecting against interference are costly. Critically, other factors, like memory load, appeared less costly. Other key factors which may drive effort costs, such as error avoidance, had minimal influence on wage requests. Our approach is sensitive to individual differences, and could be used in psychiatric populations to understand the true underlying nature of apparent cognitive deficits. Author summary: Anyone who has tried to mentally calculate how much to tip at a restaurant knows that cognitive effort can feel aversive. Doing math in your head, like most high-level cognitive abilities, depends critically on working memory (WM). We know that WM is sometimes effortful to use, but we don't know which aspects of WM use drive these effort costs. To address this question, we had participants request wages in exchange for performing various tasks that differed in their specific WM demands. Using computational models of their wage demands, we demonstrated that some aspects of WM are costly, such as bringing new information into memory and preventing interference. Other factors, like the amount of information in memory and attempts to avoid mistakes, were less costly. Our approach identified which specific subcomponents of WM are aversive. Future research could use these methods to test theories about how motivational problems might be masquerading as cognitive deficits in psychiatric populations. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and MethodsResultsConclusionsDegenerative cervical myelopathy (DCM) is the commonest cause of adult spinal cord dysfunction worldwide, for which surgery is the mainstay of treatment. At present, there is limited literature on the costs associated with the surgical management of DCM, and none from the United Kingdom (UK). This study aimed to evaluate the cost-effectiveness of DCM surgery within the National Health Service, UK.Incidence of DCM was identified from the Hospital Episode Statistics (HES) database for a single year using five ICD-10 diagnostic codes to represent DCM. Health Resource Group (HRG) data was used to estimate the mean incremental surgery (treatment) costs compared to non-surgical care, and the incremental effect (quality adjusted life year (QALY) gain) was based on data from a previous study. A cost per QALY value of <£30,000/QALY (GBP) was considered acceptable and cost-effective, as per the National Institute for Health and Clinical Excellence (NICE) guidance. A sensitivity analysis was undertaken (±5%, ±10% and ±20%) to account for variance in both the cost of admission and QALY gain.The total number of admissions for DCM in 2018 was 4,218. Mean age was 62 years, with 54% of admissions being of working age (18–65 years). The overall estimated cost of admissions for DCM was £38,871,534 for the year. The mean incremental (per patient) cost of surgical management of DCM was estimated to be £9,216 (ranged £2,358 to £9,304), with a QALY gain of 0.64, giving an estimated cost per QALY value of £14,399/QALY. Varying the QALY gain by ±20%, resulted in cost/QALY figures between £12,000 (+20%) and £17,999 (−20%).Surgery is estimated to be a cost-effective treatment of DCM amongst the UK population. [ABSTRACT FROM AUTHOR]

Objective: Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy and among the most common malignancies in young adults and requires a unique pattern of healthcare utilization including an acute/emergent presentation and an intensive initial 8 months of therapy followed by two years of outpatient treatment. The COVID-19 pandemic caused massive global disruptions in healthcare use and delivery. This report aims to examine the effects of the COVID-19 pandemic on the presentation, diagnosis and continued management of childhood and young adult ALL in regard to utilization and cost of care among commercially insured individuals in the United States. Results: Utilizing a commercial insurance claims database, 529 pediatric and young adult patients were identified who were diagnosed with ALL between January 2016 and March 2021. New diagnoses were evaluated by era and demographics. Utilization was measured by COVID-related era as number of inpatient and outpatient encounters, inpatient days, and cumulative cost during the initial 8 months of therapy. None of these cost or utilization factors changed significantly during or shortly after the pandemic. These findings reinforce that the necessary care for pediatric and young adult ALL was unwavering despite the massive shifts in the healthcare system caused by the COVID-19 pandemic. This provides a valuable benchmark as we further examine the factors that influence the pandemic's impact on health equity and access to care, especially in vulnerable pediatric and young adult populations. This is the first investigation of the effect of the COVID-19 pandemic on utilization and cost of care in pediatric and young adult cancer. [ABSTRACT FROM AUTHOR]

A zincophilic PAN@Zn(OTF)2 (PZO) separator with an extremely thin thickness of 65.6 μm is introduced. This separator with a low cost of 6.1 $ m−2, exhibiting excellent mechanical and wettability properties. The cell with the PZO separator exhibits impressive electrochemical performances both in symmetrical Zn‖‖Zn cell and Zn‖‖NVO full cell. [ABSTRACT FROM AUTHOR]

Compared to their closest ape relatives, humans walk bipedally with lower metabolic cost (C) and less mechanical work to move their body center of mass (external mechanical work, WEXT). However, differences in WEXT are not large enough to explain the observed lower C: humans may also do less work to move limbs relative to their body center of mass (internal kinetic mechanical work, WINT,k). From published data, we estimated differences in WINT,k, total mechanical work (WTOT), and efficiency between humans and chimpanzees walking bipedally. Estimated WINT,k is ~ 60% lower in humans due to changes in limb mass distribution, lower stride frequency and duty factor. When summing WINT,k to WEXT, between-species differences in efficiency are smaller than those in C; variations in WTOT correlate with between-species, but not within-species, differences in C. These results partially support the hypothesis that the low cost of human walking is due to the concerted low WINT,k and WEXT. [ABSTRACT FROM AUTHOR]

Objective: To estimate the baseline to measure one of the three indicators of the World Health Organization (WHO) End TB strategy (2015–2035), measure the costs incurred by patients affected by tuberculosis (TB) during a treatment episode and estimate the proportion of households facing catastrophic costs (CC) and associated risk factors, in Colombia, 2021. Material and methods: A nationally representative cross-sectional survey was conducted among participants on TB treatment in Colombia, using telephone interviews due to the exceptional context of the COVID-19 pandemic. The survey collected household costs (direct [medical and non-medical out-of-pocket expenses] and indirect) over an episode of TB, loss of time, coping measures, self-reported income, and asset ownership. Total costs were expressed as a proportion of annual household income and analyzed for risk factors of CC (defined as costs above 20% annual household income). Results: The proportion of TB-affected households incurring in costs above 20% annual household income (CC) was 51.7% (95%CI: 45.4–58.0) overall, 51.3% (95%CI: 44.9–57.7) among patients with drug-sensitive (DS) TB, and 65.0% (95%CI: 48.0–82.0) among drug-resistant (DR). The average patient cost of a TB case in Colombia was $1,218 (95%CI 1,106–1,330) including $860.9 (95%CI 776.1–945.7) for non-medical costs, $339 (95%CI 257–421) for the indirect costs, and $18.1 (95%CI 11.9–24.4) for the medical costs. The factors that influenced the probability of facing CC were income quintile, job loss, DR-TB patient, and TB type. Conclusion: Main cost drivers for CC were non-medical out-of-pocket expenses and income loss (indirect costs). Current social protection programs ought to be expanded to mitigate the proportion of TB-affected households facing CC in Colombia, especially those with lower income levels. [ABSTRACT FROM AUTHOR]

Simple Summary: To support decision-making in the field, a tool dedicated to Q fever for farmers and farm advisers was developed. The proposed, modified partial budgeting approach integrates a simplified yearly compartmental model and the main interactions between disorders linked to Q fever. The model concomitantly estimates the yearly burden of Q fever in herd prevaccination as well as the 3-year vaccination benefit. For herds with a moderate or high prevalence of Q fever prevaccination (>30%), a vaccination benefit was observed. The vaccine should then be seen as insurance in herds with low prevalence rates of Q fever prevaccination (≤20%). To support farmers in their decisions related to Q fever, a dedicated economic assessment tool is developed. The present work describes the calculator, its economic rationale, and the supporting assumptions. The calculator integrates a yearly compartmental model to represent population dynamism and the main interactions between disorders linked to Q fever, especially reproductive disorders (abortion, retained foetal membranes, purulent vaginal discharge and endometritis, extra services, and calving–conception delays). The effects of the nontangible cost of the disease on human health, the welfare of the animals, and the workload of farmers were not integrated into the model. The model shows high-level sensitivity to the prevalence of Q fever in the herd prevaccination and to the costs of abortion and extra days of calving–conception intervals. Breakeven points, i.e., cost values that allow us to achieve positive vaccination benefits, are also reported. For herds with moderate or high prevalence rates of Q fever prevaccination (>30%), a vaccination benefit is observed. The vaccine should be considered a type of insurance in herds with low prevalence rates of Q fever prevaccination (≤20%). The calculator was developed to aid decision-making at the farm level, and no conclusion can be extrapolated as a generic trend based on the present work. [ABSTRACT FROM AUTHOR]

Simple Summary: Sarcomas are a group of rare heterogeneous neoplasms of mesenchymal origin. Despite attendant difficulties in study of such disease states, there has been at least one US Federal Drug Administration (FDA) treatment approval for sarcomas in 8 of the last 11 years since 2013. The relative costs, as well as trends in the marketplace, for medications approved for sarcoma have heretofore been unexplored. Given the expansion of medical treatments for sarcoma subtypes in the past decade, it is vital to assess the current status of the landscape to better comprehend achieved successes, challenges, and future directions. Herein, we provide an overview of some of the trends in FDA approvals as well as their associated costs and correlations with incidence as well as outcomes. Sarcomas represent a diverse set of both malignant and benign subtypes consisting of often rare and ultra-rare conditions. Over the course of the last decade, there have been numerous FDA approvals for agents treating various sarcoma subtypes. Given this burgeoning landscape of sarcoma treatments, we seek to review current FDA-approved agents with respect to their rates of incidence, approval rates, and financial costs. We gathered clinical trial data by searching FDA approval announcements from 2013 to 2023. We determined the 30 day and one year cost of therapy for patients of FDA-approved sarcoma treatments in the aforementioned timeframe. From 2013 to 2023, 14 medications have been FDA-approved for sarcoma subtypes. The 30-day dosing prices for these medications range from $11,162.86 to $46,926.00. Since 2013, the rates of approval for sarcoma medications have been higher than in prior decades. Nonetheless, there remains the potential for significant financial toxicity for patients living with sarcoma. [ABSTRACT FROM AUTHOR]

We initiate the design and the analysis of stabilization-free Virtual Element Methods for the Poisson problem written in mixed form. A Virtual Element version of the lowest order Raviart-Thomas Finite Element is considered. To reduce the computational costs, a suitable projection on the gradients of harmonic polynomials is employed. A complete theoretical analysis of stability and convergence is developed in the case of quadrilateral meshes. Some numerical tests highlighting the actual behaviour of the scheme are also provided. [ABSTRACT FROM AUTHOR]

This article uses a transcendental logarithmic stochastic frontier cost function model to analyze the cost efficiency, cost loss efficiency, and influencing factors of large-scale pig farming in 29 provinces across China from 2012 to 2021. Research has found that the overall cost efficiency of large-scale pig farming is relatively high, with an average of 0.894, but an average annual decrease of 0.1%. Non-cost efficiency is the main factor affecting the cost efficiency of large-scale pig farming. Epidemic prevention awareness, human capital, government support, and feed compensation can significantly promote the improvement of cost efficiency in large-scale pig farming, while regional production structures will have a inhibitory effect. Therefore, in the context of rural revitalization, various regions should increase cooperation between government and enterprises, develop pig farming according to local conditions, and effectively improve the cost efficiency of pig farming. [ABSTRACT FROM AUTHOR]

Human papillomavirus (HPV) is a sexually transmitted pathogen and is the main cause of cervical cancer. Cervical cancer is the second most prevalent cancer in Indonesia. One of the prevention measures used to tackle this disease is using HPV Vaccine. Previous studies have shown that HPV vaccine acceptance is influenced by lack of knowledge regarding the vaccine, high cost, and contradicting local beliefs and faiths. The aim of this study is to identify the factors influencing HPV vaccine acceptance in ASEAN countries. Three databases were searched for qualitative and quantitative studies published up to August 2023. Papers were included if they were in English or Indonesian, available in full text, and had a focus on knowledge, cost, beliefs, acceptance of the HPV vaccine. Among 23 studies, most mentioned factors regarding HPV vaccination acceptance are knowledge, cost, and beliefs. Despite being frequently discussed, knowledge doesn't always represent vaccine acceptance rate. There are no contradictions found regarding cost as a factor within those studies. Vaccination cost is the main factor that influences HPV vaccine acceptance. Though a common factor, knowledge may not always represent HPV vaccine acceptance. Other factors such as beliefs also contribute to HPV vaccine's acceptance in ASEAN countries. [ABSTRACT FROM AUTHOR]