Hasil untuk "Costs"

João Magalhães MSc, Roberto Zambelli PhD, Otaviano Junior et al.

Research Type: Level 3 - Retrospective cohort study, Case-control study, Meta-analysis of Level 3 studies Introduction/Purpose: Surgical site infections (SSIs) account for 31% of all hospital-acquired infections, significantly impacting postoperative recovery and healthcare costs. Foot and ankle surgeries present infection rates between 0.5% and 6.5%, with trauma cases and comorbidities being key risk factors. Despite previous studies, long-term data on infection incidence and predictive factors remain limited. This 7-year cohort study aimed to determine the incidence of SSIs in foot and ankle surgeries and identify independent predictors of infection, particularly differentiating superficial and deep infections. Understanding these risk factors is essential for optimizing infection control protocols and refining perioperative management strategies to improve surgical outcomes. Methods: This retrospective cohort study included 2,180 patients undergoing foot and ankle surgery between 2014 and 2020 in a private hospital. Elective and trauma-related procedures were included, excluding cases of pre-existing infections, open fractures, and septic arthritis. SSIs were classified as superficial (requiring local wound care or oral antibiotics) or deep (requiring surgical debridement or implant removal). Data on age, sex, diabetes mellitus (DM), systemic arterial hypertension (SAH), smoking, ASA score, and BMI were collected. Multivariate logistic regression was used to assess independent predictors of SSIs, with statistical significance set at p < 0.05. The primary outcome was infection incidence, while secondary outcomes included risk factor analysis and infection severity stratification. Results: The overall SSI incidence was 4% (83/2,180 cases), with 2.8% superficial and 1.2% deep infections. Smoking (OR 2.9, 95% CI 1.4–5.3, p = 0.001) and ASA score >2 (OR 3.4, 95% CI 1.2–8.4, p = 0.013) were independent predictors of infection. The deep infection group had significantly higher rates of smoking (p = 0.002), systemic hypertension (p = 0.018), and trauma-related procedures (p = 0.049). No significant associations were found between infection and diabetes mellitus (p = 0.404) or obesity (p = 0.816). Trauma surgeries, particularly ankle fractures, had the highest infection rates, reinforcing the need for enhanced infection control measures in high-risk patients. Conclusion: This 7-year cohort study confirmed a 4% SSI incidence in foot and ankle surgeries, with smoking and ASA score >2 emerging as significant risk factors. Trauma-related procedures, particularly ankle fractures, had higher infection rates, emphasizing the importance of preoperative risk stratification and perioperative infection control. Surprisingly, diabetes and BMI were not significant predictors, possibly due to effective preoperative optimization. These findings support the implementation of targeted preventive strategies, particularly in high-risk patients, to reduce infection rates and improve surgical outcomes. Characterization of the sample according to the presence of infection This table presents the demographic and clinical characteristics of patients undergoing foot and ankle surgery, stratified by infection status (no infection, superficial infection, and deep infection). Trauma cases (p = 0.049), arterial hypertension (p = 0.018), ASA score ≥ II (p < 0.001), smoking (p = 0.002), and overweight status (p = 0.002) were significantly associated with infection. Diabetes mellitus (p = 0.687) and BMI (p = 0.321) were not statistically significant predictors. The findings suggest that preoperative risk factors such as smoking, ASA score, and hypertension should be considered in infection prevention strategies for foot and ankle surgery patients.

Cristiano Manetti da Cruz, Mercia Pandolfo Provin, Ana Laura de Sene Amâncio Zara

Objectives: To identify expenses with the purchase of medicines and supplies by the Municipal Health Department of Canguçu/RS, through legal proceedings, from 2017 to 2021. Methods: It is a quantitative, descriptive, and retrospective study, using the docu-ment analysis technique. Secondary data on public costs, available on the Transparency Portal, were used. The amounts spent and the origins of the resources used for the acqui-sition of these drugs were analyzed. Results: There was an increase of 297.93% in spen-ding on legal proceedings for the acquisition of medicines and pharmaceutical supplies through judicial blockades. Of these, more than 76% refer to antineoplastic medications. The basic care budget increased by 132.41% in this period and the costs of pharmaceu-tical assistance almost doubled from R$ 854,248.86, in 2017, to R$ 1,524,871.92, in 2021, with a significant increase during the pandemic period. Comparing the expen-diture on purchasing medicines through blockages by court permits in 2021 and the amount spent on pharmaceutical assistance in the same period, it is noted that the cost is very similar, but a small portion of the population is served through judicialization. Conclusions: There was a considerable increase in spending on purchasing medicines due to court decisions. The Municipal Health Department is obliged to acquire medicines that do not belong to the Municipal Medication List, through judicial blocking of public accounts, because the government of the State of Rio Grande do Sul does not send these medicines to users with approved lawsuits.

Behdad Sadeghi, Rahmatollah Gholipour, Mojtaba Amiri et al.

Objective This study was conducted with the goal of designing a policy-making model for sports in Iran, with a focus on the development of 'sport for all'. In terms of purpose, this study is classified as applied research, as it encompasses practical aspects for various organizations related to sports and health, in addition to providing awareness and scientific insights. Furthermore, this research is exploratory in nature, as it aims to design a model on a novel and innovative topic. Methods A mixed qualitative-quantitative method was employed in this study. The qualitative component was conducted using a situation analysis approach, which is one of the methods of grounded theory. The qualitative research involved interviewing experts; thus, 12 experts in the fields of policy making and sport management were interviewed. These experts were either professors or managers of organizations related to sports, possessing over a decade of executive and decision-making experience. Sampling was carried out using targeted and snowball methods. The quantitative section utilized interpretative structural modeling, an approach based on expert opinions, effective for exploring qualitative variables with mutual effects at various levels of importance. Results After an in-depth examination of the interviews and the data obtained, each interview was analyzed individually to extract initial codes. Subsequently, concepts and categories were developed. Messy situational maps, ordered situational maps, and social worlds/arenas maps were identified. The primary categories of the sport policy-making model in Iran for the development of 'sport for all' include contextual factors, mediating factors, role players and influential institutions, executive requirements, environmental complexities, risks, legal problems, external organizational factors, costs and expenses, and interorganizational challenges. With the aid of interpretive structural modeling, conceptual modeling was conducted. Role players and influential institutions emerged as the most significant factors in Iran's sport policy-making process, possessing the highest influence and the least dependence compared to other factors. Conclusion Given that 'sport for all' should be elevated to the level of the country's macro policies, and its development and progress should be approached as a complex issue, the policy for the development of 'sport for all' becomes especially important. Policymakers should give it significant attention. Role players and influential institutions in Iran's sports policy-making process require substantial coordination due to their numerous connections and conflicts. In Iran, 'sport for all' and organized recreation have received limited attention, and currently, there is no mechanism for monitoring sports policies and their continuous implementation. Therefore, it is recommended to implement a national physical activity monitoring plan based on a comprehensive and electronic system. Since the involvement of managers and executives, as well as their cooperation with policymakers in the policy formation process, is crucial, policymakers should be as involved as possible in the implementation process. Additionally, conditions should be facilitated to enable the private sector to effectively engage in this field.

Mohamed Hosin ElNeiri, Abdel Sattar Abdel Hamid Dahab, Abdulaziz Mohamed Abdulaziz et al.

The application of laser in the drilling and perforation of oil wells can achieve great benefits such as reduced drilling costs and time with a higher rate of penetration (ROP) and elimination of casing necessity in oil and gas well drilling. This paper presents an original experimental investigation of Laser cutting through Hashma sandstone (a common quarry rock in Egypt) to develop a good understanding of the laser cutting process in sandstone. Five blocks of Hashma sandstone with dimensions of 35 cm × 35 cm × 10 cm were utilized to study the effects of the various parameters involved in the lasing (cutting) process in order to evaluate the cutting process through sandstone, investigate the effect of laser parameters on the process and the cutting mechanisms. The experimental results showed that the laser drilling can provide lower specific energy (SE) compared to conventional drilling methods, revealed the effect of various laser and rock parameters (such as beam power, intensity, duration, sample size, and orientation) on the cutting process, and demonstrated the laser cutting mechanisms through sandstone such as thermal spallation and melting mechanisms. Several parameters must be optimized for an optimum laser cutting process with the lowest SE, such as using the optimum beam power, beam duration (or Lasig time), and beam mode (continuous or pulsed). The optimum parameters may change from one case to another and depend on the overall interactions among the various variables such as thermal dissipation rate and purging system efficiency.

А. P. Levitskiy, Yu. A. Levitskiy, I. A. Selivanska et al.

The work shows that Fatty acids of dietary fats provide two main functions in the human and animal body: energy and structural-regulatory, Polyunsaturated fatty acids (PUFA) are the basis of membrane lipids of all cells of the body The structure and functional activity of cells, their resistance to pathogenic factors depends on the ratio of ω-6 / ω-3 PUFA. Аdherence to recommended metabolic energy reserves in poultry feed is essential to optimize feed costs. The use of oils or fats is a common economic practice in modern poultry production. Energy functions are carried out due to the oxidation of energy fatty acids in mitochondria, which include, first of all, palmitic (С16:0), palmitooleic (С16:0), stearic (С18:1) and oleic (С18:1). In addition to providing energy, edible oil can also enhance dietary palatability, reduce dustiness, and increase lipoprotein hydrolysis to promote the production of essential fatty acids. Adipose tissue should be considered not only as a source of various fatty acids, but also as an important endocrine organ that takes an active part in the activity of the immune system. To determine the effect of a diet with high oleic sunflower oil on the content of energy fatty acids (EFA) and long-chain PUFA (LCPUFA) in rat liver lipids. We used high oleic sunflower oil (HOSO) containing 85.5% oleic acid. The rats were fed a fat-free diet (FFD) and diets with 5 or 15% HOSO for 35 days. Lipids were extracted from the liver and separated into three fractions: neutral lipids (NL), phospholipids (PL) and free fatty acids (FFA). The fatty acid composition of lipid fractions was determined by gas chromatography. FFA are the sum of the following acids:С16:0, С16:1, С18:0, С18:1andС18:2. LCPUFA are presented С20:4 ω-6, С20:5 ω-3, С22:5 ω-3and С22:6 ω-3. Most of all, EFA is contained in the NL fraction (89%), then in the PL fraction (79%), and least of all in the FFA fraction (68%). LCPUFA is found most of all in the FFA fraction (20%), then in the PL fraction (13%), and least of all in the NL fraction (2%). In rats that received fat diets, the content of EFA increased in the NL fraction by 2-3%, in the FFA fraction by 5-8%, and did not change in the PL fraction. The content of LCPUFA ω-6 (arachidonic acid) with fat nutrition dose-dependently decreases in the fraction of NL and FFA and does not change in the fraction of PL. On the contrary, the content of ω-3 LCPUFA increases in rats treated with HOSO in all lipid fractions. Also, the ω-6/ω-3 LCPUFA ratio is significantly reduced in rats treated with HOSO. Consumption of HOSO stimulates endogenous biosynthesis of ω-3 LCPUFA.

Susmita Chatterjee, Palash Das, Aaron Shikhule et al.

Historically, economic studies on tuberculosis estimated out-of-pocket expenses related to tuberculosis treatment and catastrophic cost, however, no study has yet been conducted to understand the post-treatment economic conditions of the tuberculosis patients in India. In this paper, we add to this body of knowledge by examining the experiences of the tuberculosis patients from the onset of symptoms till one-year post-treatment. 829 adult drug-susceptible tuberculosis patients from general population and from two high risk groups: urban slum dwellers and tea garden families were interviewed during February 2019 to February 2021 at their intensive and continuation phases of treatment and about one-year post-treatment using adapted World Health Organization tuberculosis patient cost survey instrument. Interviews covered socio-economic conditions, employment status, income, out-of-pocket expenses and time spent for outpatient visits, hospitalization, drug-pick up, medical follow-ups, additional food, coping strategies, treatment outcome, identification of post-treatment symptoms and treatment for post-treatment sequalae/recurrent cases. All costs were calculated in 2020 Indian rupee (INR) and converted into US dollar (US$) (1 US$ = INR 74.132). Total cost of tuberculosis treatment since the onset of symptom till one-year post-treatment ranged from US$359 (Standard Deviation (SD) 744) to US$413 (SD 500) of which 32%-44% of costs incurred in pre-treatment phase and 7% in post-treatment phase. 29%-43% study participants reported having outstanding loan with average amount ranged from US $103 to US$261 during the post-treatment period. 20%-28% participants borrowed during post-treatment period and 7%-16% sold/mortgaged personal belongings. Therefore, economic impact of tuberculosis persists way beyond treatment completion. Major reasons of continued hardship were costs associated with initial tuberculosis treatment, unemployment, and reduced income. Therefore, policy priorities to reduce treatment cost and to protect patients from the economic consequences of the disease by ensuring job security, additional food support, better management of direct benefit transfer and improving coverage through medical insurances need consideration.

Shermukhamedov U. Z., Karimova A. B., Abdullaev A. R. et al.

The article considers two options for the design of an overpass with a beam-cut and a beam-continuous static scheme. An inspection of the technical condition of beam-cut reinforced concrete bridges in operation in Tashkent built in 1970-90 was conducted. Estimating the maintenance costs of overpasses with different static schemes operating for the last 50 years shows that the continuous reinforced concrete option drastically reduces the cost of repair work in operation. This, in turn, has a cumulative effect on the development of the bridge-building industry in the Republic of Uzbekistan. The predicted operating costs of overpasses with different static schemes during operation for 50 years showed that in a continuous reinforced concrete option, 435,803,803 soums are saved annually. The most important thing is that the proposed solution dramatically reduces the cost of repair work. This, in turn, has a cumulative effect on the development of the bridge-building industry in the Republic of Uzbekistan.

Xusheng Ai, Melissa C Smith, Frank Alex Feltus

Abstract The remarkable flexibility and adaptability of generative adversarial networks (GANs) have led to the proliferation of its models in bioinformatics research. Proteomic and transcriptomic profiles have been shown to be promising methods for discovering and identifying disease biomarkers. However, those analyses were performed by trained human examiners making the process tedious, time consuming, and hard to standardize. With the development of GANs, it is now possible to reduce computational costs and human time for bioinformatics analysis to produce effective biomarkers. Moreover, GANs help address the lack of phenotypic state transitional gene expression data as well as avoid protected human data constraints by generating RNA sequencing (RNA‐seq) data from random vectors. The purpose of this review is to summarize the use of GAN approaches and techniques to augment RNA‐seq expression data and identify clinically useful biomarkers. We compare different studies that use different types of GAN models to examine the biomarkers. Also, we identify research gaps and challenges that apply GANs to bio‐informatics. Finally, we propose potential directions for future research.

ZHANG Zhe, LIN Yin, CHEN Zixuan et al.

At present， energy storage is characterized by its high investment cost and indefinite income that hinders its large-scale promotion on the user side. It has now become a problem that demands prompt investigation to lower investment costs and increase profits. Firstly， the equipment structure of user-side shared energy storage is proposed， and load behaviors of users are analyzed and users are divided into four kinds. Secondly， peak-valley arbitrage income， capacity reduction income of transformers， investment cost， and operation cost are quantified. The dynamic return on investment period is used as the evaluation index to establish the life cycle economic benefit evaluation model based on user-side shared energy storage. To maximize peak-valley arbitrage income on a typical day， an optimal dispatching model of user-side shared energy storage is constructed to optimize the charging and discharging strategy of energy storage. Finally， a user in an industrial park is taken as an example to comprehensively analyze the investment benefits of a user-participated shared energy storage scheme from the perspective of economy and safety. The research results are of certain guiding significance to the present energy storage commercialization and application.

Mark J. Lambrechts, Devin D. St. Clair, Jinpu Li et al.

Study Design Retrospective study. Purpose To identify the rate of positive acid-fast bacillus (AFB) and fungal cultures during spine debridement, determine whether these infections are more common in certain spine segments, identify comorbidities associated with these infections, and determine whether the universal performance of fungal and AFB cultures during spine debridement is cost effective. Overview of Literature Spine infections are associated with significant morbidity and costs. Spine fungal and AFB infections are rare, but their incidence has not been well documented. As such, guidance regarding sample procurement for AFB and fungal cultures is lacking. Methods A retrospective review of medical record data from patients undergoing spine irrigation and debridement (I&D) at the University of Missouri over a 10-year period was performed. Results For patients undergoing spine I&D, there was a 4% incidence of fungal infection and 0.49% rate of AFB infection. Steroid use was associated with a higher likelihood (odds ratio, 5.62; 95% confidence interval, 1.33–23.75) of positive fungal or AFB cultures. Although not significant, patients undergoing multiple I&D procedures had higher rates of positive fungal cultures during each subsequent I&D. Over a 10-year period, if fungal cultures are obtained for each patient, it would cost our healthcare system $12,151.58. This is compared to an average cost of $177,297.64 per missed fungal infection requiring subsequent treatment. Conclusions Spine fungal infections occur infrequently at a rate of 4%. Physicians should strongly consider obtaining samples for fungal cultures in patients undergoing spine I&D, especially those using steroids and those undergoing multiple I&Ds. Our AFB culture rates mirror the false positive rates seen in previous orthopedic literature. It is unlikely to be cost effective to send for AFB cultures in areas with low endemic rates of AFB.

John F. Benson, Heather N. Abernathy, Jeff A. Sikich et al.

Abstract Wildlife strongly alter behaviour in response to human disturbance; however, fundamental questions remain regarding the influence of human infrastructure and activity on animal movement. The Covid‐19 pandemic created a natural experiment providing an opportunity to evaluate wildlife movement during a period of greatly reduced human activity. Speculation in scientific reviews and the media suggested that wildlife might be increasing movement and colonizing urban landscapes during pandemic slowdowns. However, theory predicts that animals should move and use space as efficiently as possible, suggesting that movement might actually be reduced relative to decreased human activity. We quantified space use, movement, and resource‐selection of 12 GPS‐collared mountain lions (eight females, four males) occupying parklands in greater Los Angeles during the Spring 2020 California stay‐at‐home order when human activity was far below normal. We also tested the hypothesis that reduced traffic on Los Angeles area roadways increased permeability of these barriers to animal movement. Contrary to expectations that wildlife roamed more widely during pandemic shutdowns, resident mountain lions used smaller areas and moved shorter distances relative to their historical behaviour in greater Los Angeles. They also relaxed avoidance of anthropogenic landscape features such as trails and development, which likely facilitated increased travelling efficiency. However, there was no detectable change in road‐crossing, despite reduced traffic volume. Our results support the theoretical prediction that animals maximize movement efficiency and suggest that carnivores incur energetic costs while avoiding humans. While mountain lions may restrict movement at the landscape level relative to barriers, they appear to increase distances moved at finer scales when avoiding human activity – highlighting the scale‐dependent nature of animal responses to human disturbance. Avoiding humans can reduce direct mortality of large carnivores and is often suggested to be an important mechanism promoting coexistence in shared landscapes. However, energetic costs incurred by increased movement and space‐use while avoiding human activity may have important consequences for population viability, predator–prey interactions, community structure, and human–wildlife conflict. Management providing sufficient wild prey and education regarding best practices for protection of domestic animals are important for conserving large carnivores in human‐dominated landscapes.

Dariusz Milewski

The paper deals with the economic efficiency of decentralized and centralized strategies of distribution goods in terms of both internal efficiency of firms and external costs of logistics processes (first of all external costs of transport). The author developed a model (using an electronic spreadsheet) in order to calculate the economical efficiency in the micro and macro dimensions in order to find the distances on which distribution using one central warehouse is more profitable than decentralized distribution. The results of the simulations show that the strategy of centralized inventories can be in many cases an economically effective strategy although not for deliveries on very long distance. The results confirm that the benefits of centralization are lower inventories, although the simulations do not confirm the applicability of the square root law to calculate the level of inventories. However, they confirm a positive impact on the level of logistic customer service, measured by the availability of stocks. Better service is probably the main benefit of this strategy. In order to investigate the impact of individual parameters on the total costs of logistics processes 1300 simulations were carried out for various cases: The volume of annual sales, fluctuations in demand, the value of distributed goods, the number of warehouses in a decentralized system and the width of the product range, costs of warehousing, and maintaining stocks, and the distance of transport and in deliveries to customers.

Dirk Heider, Herbert Matschinger, Andreas D Meid et al.

<h4>Background</h4>In the growing population of the elderly, drug-related problems are considered an important health care safety issue. One aspect of this is the prescription of potentially inappropriate medication (PIM) which is considered to increase health care costs.<h4>Objective</h4>Using data from the Health Economics of Potentially Inappropriate Medication (HEPIME) study, we aimed to analyze how the number of prescribed substances moderates the association of PIM use as defined by the German PRISCUS list and health care costs applying a longitudinal perspective.<h4>Methods</h4>An initial number of 6,849,622 insurants aged 65+ of a large German health insurance company were included in a retrospective matched cohort study. Based on longitudinal claims data from the four separate quarters of a 12-month pre-period, 3,860,842 individuals with no exposure to PIM in 2011 were matched to 508,212 exposed individuals. Exposure effects of PIM use on health care costs and the number of prescribed substances were measured based on longitudinal claims data from the four separate quarters of the 12-month post-period.<h4>Results</h4>After successful balancing for the development of numerous matching variables during the four quarters of the pre-period, exposed individuals consumed 2.1 additional prescribed substances and had higher total health care costs of 1,237 € when compared to non-exposed individuals in the 1st quarter of the post-period. Controlling for the number of prescribed substances, the difference in total health care costs between both study groups was 401 €. The average effect of one additionally prescribed substance (other than PIM) on total health care costs was increased by an amount of 137 € for those being exposed to a PIM. In quarters 2-4 of the post-period, the differences between both study groups tended to decrease sequentially.<h4>Conclusions</h4>PIM use has an increasing effect on the development of health care costs. This cost-increasing effect of PIM use is moderated by the number of prescribed substances.

Beth O'Reilly, Jennifer Isenor, Susan Bowles

On 10 December 2010 An Act to Amend Chapter 36 of the Acts of 2001, the Pharmacy Act (Bill 7) received Royal Assent in Nova Scotia, including an amendment that enabled an expanded scope of pharmacy practice. Expanding pharmacists' scope of practice came about from recommendations by various federal and provincial government bodies as an attempt to improve accessibility to health care and decrease costs. In 2013, pharmacists in Nova Scotia began administering the influenza vaccine as part of the publicly funded program in attempts to improve vaccine coverage rates. Preliminary evaluation in Nova Scotia has shown an increase in influenza vaccination coverage. Although pharmacist administration of influenza vaccination may improve vaccination coverage and reduce demand on physician time, there may be tension created among the professions, which needs to be addressed and managed.

Partridge, Stephanie R, Balestracci, Kate, Wong, Annette TY et al.

BackgroundYounger adults are difficult to engage in preventive health, yet in Australia they are gaining more weight and increasing in waist circumference faster than middle-to-older adults. A further challenge to engaging 18- to 35-year-olds in interventions is the limited reporting of outcomes of recruitment strategies. ObjectiveThis paper describes the outcomes of strategies used to recruit young adults to a randomized controlled trial (RCT), healthy lifestyle mHealth program, TXT2BFiT, for prevention of weight gain. The progression from enquiry through eligibility check to randomization into the trial and the costs of recruitment strategies are reported. Factors associated with nonparticipation are explored. MethodsParticipants were recruited either via letters of invitation from general practitioners (GPs) or via electronic or print advertisements, including Facebook and Google—social media and advertising—university electronic newsletters, printed posters, mailbox drops, and newspapers. Participants recruited from GP invitation letters had an appointment booked with their GP for eligibility screening. Those recruited from other methods were sent an information pack to seek approval to participate from their own GP. The total number and source of enquiries were categorized according to eligibility and subsequent completion of steps to enrolment. Cost data and details of recruitment strategies were recorded. ResultsFrom 1181 enquiries in total from all strategies, 250 (21.17%) participants were randomized. A total of 5311 invitation letters were sent from 12 GP practices—16 participating GPs. A total of 131 patients enquired with 68 participants randomized (68/74 of those eligible, 92%). The other recruitment methods yielded the remaining 182 randomized participants. Enrolment from print media was 26% of enquiries, from electronic media was 20%, and from other methods was 3%. Across all strategies the average cost of recruitment was Australian Dollar (AUD) $139 per person. The least expensive modality was electronic (AUD $37), largely due to a free feature story on one university Web home page, despite Facebook advertising costing AUD $945 per enrolment. The most expensive was print media at AUD $213 and GP letters at AUD $145 per enrolment. ConclusionsThe research indicated that free electronic media was the most cost-effective strategy, with GP letters the least expensive of the paid strategies in comparison to the other strategies. This study is an important contribution for future research into efficacy, translation, and implementation of cost-effective programs for the prevention of weight gain in young adults. Procedural frameworks for recruitment protocols are required, along with systematic reporting of recruitment strategies to reduce unnecessary expenditure and allow for valuable public health prevention programs to go beyond the research setting. Trial RegistrationAustralian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12612000924853; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=362872 (Archived by WebCite at http://www.webcitation.org/6YpNfv1gI).

Ramez M Alkoudmani, Ramadan M Elkalmi

Web-based learning and web 2.0 tools which include new online educational technologies (EdTech) and social media websites like Facebook® are playing crucial roles nowadays in pharmacy and medical education among millennial learners. Podcasting, webinars, and online learning management systems like Moodle® and other web 2.0 tools have been used in pharmacy and medical education to interactively share knowledge with peers and students. Learners can use laptops, iPads, iPhones, or tablet devices with a stable and good Internet connection to enroll in many online courses. Implementation of novel online EdTech in pharmacy and medical curricula has been noticed in developed countries such as European countries, the US, Canada, and Australia. However, these trends are scarce in the majority of Arabic language speaking countries (ALSC), where traditional and didactic educational methods are still being used with some exceptions seen in Palestine, Kuwait, Jordan, Saudi Arabia, Egypt, UAE, and Qatar. Although these new trends are promising to push pharmacy and medical education forward, major barriers regarding adaptation of E-learning and new online EdTech in Arab states have been reported such as higher connectivity costs, information communication technology (ICT) problems, language barriers, wars and political conflicts, poor education, financial problems, and lack of qualified ICT-savvy educators. More research efforts are encouraged to study the effectiveness and proper use of web-based learning and emerging online EdTech in pharmacy education not only in ALSC but also in developing and developed countries.

Ali Asghar Isalou, Hossein Ebrahimzadeh, Behzad Shahmoradi

During recent decades, the issue of regeneration of urban inefficient and old textures has become one of key issues in the field of urban development strategies. For this purpose, the managers and urban policy makers have used different measures including increase of building density, improvement and modernization of old textures, mass construction, etc. some of these policies are practiced in the form of direct interventions by urban management system in order to provide public services and facilities and or improvement of old tissues. Unfortunately, lack of considering the effective social, economic and physical parameters in an effective manner concerning the capacity of urban tissues for intervention from the practitioners and authorities of urban development affairs has led to emergence of some problems during execution of civil projects such as delay in execution time of projects, high costs and or social dissatisfactions. On this basis, the present study, tries to determine the intervention  of  the old and inefficient tissues of Qom city with the help of three main indicators: physical, economic and social indices to perform the measures more effectively. Of course, if all these criteria are followed together with their sub-criteria, so that some complications would emerge in decision making process.  Therefore, in order to facilitate decision making process, we used analytic network process (ANP) for achieving the objectives of present study. Our findings revealed that out of 76 ha area of District 6 Qom City, 20.3 percent has low intervention-capability and 41.8 percent have medium intervention-capability.  While 37.9 percent of this district area has high intervention-capability, which could be contributed to the existence of the vast arid lands within the texture.

Maria Calderon, Carlos J. Bernardos, Marco Gramaglia

Induction loop detectors have become the most utilized sensors in traffic management systems. The gathered traffic data is used to improve traffic efficiency (i.e., warning users about congested areas or planning new infrastructures). Despite their usefulness, their deployment and maintenance costs are expensive. Vehicular networks are an emerging technology that can support novel strategies for ubiquitous and more cost-effective traffic data gathering. In this article, we propose and evaluate VIL (Virtual Induction Loop), a simple and lightweight traffic monitoring system based on cooperative vehicular communications. The proposed solution has been experimentally evaluated through simulation using real vehicular traces.

Smits Niels

<p>Abstract</p> <p>Background</p> <p>The Youden index, the sum of sensitivity and specificity minus one, is an index used for setting optimal thresholds on medical tests.</p> <p>Discussion</p> <p>When using this index, one implicitly uses decision theory with a ratio of misclassification costs which is equal to one minus the prevalence proportion of the disease. It is doubtful whether this cost ratio truly represents the decision maker's preferences. Moreover, in populations with a different prevalence, a selected threshold is optimal with reference to a different cost ratio.</p> <p>Summary</p> <p>The Youden index is not a truly optimal decision rule for setting thresholds because its cost ratio varies with prevalence. Researchers should look into their cost ratio and employ it in a decision theoretic framework to obtain genuinely optimal thresholds.</p>