Tornado Analysis Research Articles

Spatial Analysis Of Tornadoes In The US

Tornadoes are among the most devastating meteorological hazards, causing significant destruction and losses each year across the United States. This study aims to identify the regions and states that are particularly vulnerable to tornado threats, while also providing deeper insights into the geographic patterns that influence tornado activity. By leveraging geoprocessing tools, historical data was analyzed to visualize various aspects, including tornado density, seasonality, and the regions most impacted in terms of fatalities, injuries, and property damage. The analysis reveals that certain states, notably Texas, Alabama, and Oklahoma, emerge as hotspots with heightened exposure to tornado risks. Texas, in particular, stands out due to its high frequency of tornado occurrences and substantial property losses, underscoring its vulnerability. Additionally, the study highlights that these states experience significant variations in tornado activity, which are often influenced by seasonal patterns. The findings contribute to a more comprehensive understanding of tornado distribution, enabling better risk assessment and potentially informing more effective disaster preparedness strategies to mitigate future impacts in these high-risk areas.

Caprock sealing integrity and key indicators of CO2 geological storage considering the effect of hydraulic-mechanical coupling: X field in the Bohai Bay Basin, China

Caprock sealing efficiency is an essential guarantee for the long-term safety and stability of CO2 geological storage (CCS). However, the uncertainty in the physical and mechanical properties of deep formations poses challenges to accurately predict the risks of CO2 leakage resulting in CO2 breakthrough or caprock fracture. This study aims to address the issue of imperfect key indicators for caprock sealing by focusing on the CCS project in the Bohai Bay Basin, China. A hydraulic-mechanical (HM) coupling program without considering multiphase flow and the chemical reactions is secondary developed based on the finite element software ABAQUS. Furthermore, a three-dimensional finite element numerical model is established for the analysis of HM coupling, with pore pressure increment (∆PP), Coulomb failure stress (∆CFS) and displacement (U) as evaluation criteria. The Tornado analysis and response surface analysis are employed to analyze the impact of 17 indicators on the caprock sealing, including caprock thickness, burial depth, reservoir and caprock permeability parameters, and mechanical parameters. Subsequently, key performance indicators for caprock sealing are determined. The research results indicate that the reservoir permeability, injection rate, caprock permeability, caprock Young's modulus, caprock internal friction angle, caprock Poisson's ratio, and caprock burial depth are key indicators of caprock sealing capability. The reservoir permeability has a greater impact sensitivity compared to the caprock permeability. Pore pressure and displacement increase with increasing in reservoir permeability. The caprock's resistance to deformation and fracturing increases with increasing in Young's modulus and Poisson's ratio of caprock. This study provides valuable insights for evaluating caprock sealing during CO2 storage in saline aquifers.

Key indicators of caprock sealing assessment with consideration of faults in potential CO2 geological storage sites in Subei Basin, China

Good caprock sealing is crucial for ensuring the long-term safety and security of carbon dioxide (CO2) geological storage. However, concealed faults within caprocks and reservoirs can impact the transport and accumulation of CO2 plumes. Due to the uncertainties associated with the geometric structure, physical properties, and combined relationships among reservoir, caprock and fault, accurately evaluating caprock sealing is challenging. To address the challenge of identifying key indicators for caprock sealing considering faults, this study focuses on the one potential CO2 geological storage field in the Subei Basin, China. First, this study establishes a hydraulic-mechanical (HM) coupled finite element model considering a combination of caprock, reservoir and fault. Then, 22 research indicators, including fault offset, fault dip, caprock thickness, burial depth, permeability and mechanical properties, are analysed to evaluate their influence on caprock sealing via the tornado analysis and response surface methods. Finally, key indicators are determined based on evaluation criteria, such as pore pressure increment (ΔPP) and Coulomb failure stress (CFS), in the fault plane. The research results indicate that fault dip, fault offset, fault permeability, burial depth, and reservoir permeability are key indicators. The caprock thickness, caprock permeability, and caprock Young's modulus significantly influence the caprock sealing capacity. The ΔPP and CFS increase with increasing fault dip and offset. When the fault dip exceeds 45°, the ΔPP and CFS reach maximum values at the interface between the reservoir and caprock. Fault permeability has a greater impact than reservoir permeability and caprock permeability. The research results may provide guidance for the evaluation of caprock sealing capacity for CO2 geological storage.

Hysterectomy versus chemotherapy for low-risk non-metastatic gestational trophoblastic neoplasia (GTN): A cost-effectiveness analysis

ObjectiveDetermine the cost-effectiveness for hysterectomy versus standard of care single agent chemotherapy for low-risk gestational trophoblastic neoplasia (GTN). MethodsA cost-effectiveness analysis was conducted comparing single agent chemotherapy with hysterectomy using decision analysis and Markov modeling from a healthcare payer perspective in Canada. The base case was a 40-year-old patient with low-risk non-metastatic GTN that completed childbearing. Outcomes were life years (LYs), quality-adjusted life years (QALYs), incremental cost-effectiveness ratio (ICER), and adjusted 2022 costs (CAD). Discounting was 1.5% annually and the time horizon was the patient's lifetime. Model validation included face validity, deterministic sensitivity analyses, and scenario analysis. ResultsMean costs for chemotherapy and hysterectomy arms were $34,507 and $17,363, respectively, while effectiveness measure were 30.37 QALYs and 31.04 LYs versus 30.14 QALYs and 30.82 Lys, respectively. The ICER was $74,526 (USD $54,516) per QALY. Thresholds favoring hysterectomy effectiveness were 30-day hysterectomy mortality below 0.2% and recurrence risk during surveillance above 9.2% (low-risk) and 33.4% (high-risk). Scenario analyses for Dactinomycin and Methotrexate led to similar results. Sensitivity analysis using tornado analysis found the cost to be most influenced by single agent chemotherapy cost and risk of resistance, number of weeks of chemotherapy, and probability of postoperative mortality. ConclusionCompared to hysterectomy, single agent chemotherapy as a first-line treatment costs $74,526 for each additional QALY gained. Given that this cost falls below the accepted $100,000 willingness-to-pay threshold and waitlist limitations within public healthcare systems, these results support the continued use of chemotherapy as standard of care approach for low-risk GTN.

Tensor analysis of tornadoes: a new analytical and numerical model

This research proposes a new mathematical formulation of tornadoes based on the theory of tensor analysis and simulation in a non-inertial dynamics framework, both in two and three dimensions. This model may show the spherical upward movement of air in a tornado without taking into account vertical convection. A tornado requires several elements, including geocentric latitude, the Coriolis effect, increased airspeed in the upper atmosphere, and increased air pressure. Computing the three-dimensional location of the tornado or hurricane, as well as the mathematical models of airflow motion and the Earth's rotation in three-dimensional (3D) space, can determine a tornado's airflow characteristics. To show tornado patterns, we employed computer software that computed motion dynamics and did numerical computations. The results of 2-D modeling and simulation indicated that the greater the initial tornado angular speed, the larger the tornado area. Three-dimensional modeling and simulation also show that tornadoes are more powerful at higher geocentric latitude angles. The novelty of this study is that this model can be used to explain tornado patterns. In our research, we combine tensor analysis, computational modeling, as well as 2D and 3D simulations for simulating tornadoes for the first time. The scientific application of this finding is that researchers at the Meteorology, Climatology, and Geophysics Agency will be able to analyze a tornado and geophysical phenomena more readily with simulations and models.

Bayesian Analysis of Spatial Model for Frequency of Tornadoes

Frequency analysis of tornadoes is very important for risk analysis and disaster control. In this paper, the annual frequency of tornadoes that occurred in the United States from 1967 to 2016 is analyzed. The simple analysis shows that frequencies of tornadoes of different sites are spatially correlated and over-dispersed. To explain the two characteristics of the data, the Bayesian hierarchical model is proposed. For comparison purposes, the Bayesian model with negative binomial distribution, Poisson distribution, Polya distribution, and first-order, non-negative, integer-valued autoregressive model with Bell innovations(BL-INAR(1)) are considered to fit the frequency of tornado. The distribution parameters of all sites are assumed to be spatially correlated, and the corresponding Bayesian hierarchical models were established. MCMC (Markov Chain Monte Carlo) method is applied to parameter estimations and relative statistical inference. By comparison of the analysis results, the negative binomial distribution is recommended to analyze the overdispersion and spatial correlation among the sites of the data. The comparison between the simulated frequencies based on the proposed model and the actual frequencies also verifies that the proposed method is a better model for the data.

Cost-Effectiveness of Universal Repeat Screening for HIV in the Third Trimester of Pregnancy

Screening all pregnant individuals for HIV in the first trimester in pregnancy has long been the standard of care in the United States, with only select populations deemed at higher risk receiving repeat screening in the third trimester. However, HIV acquisition during pregnancy significantly increases the risk of mother-to-child transmission (MTCT), and questions remain as to whether broadening third trimester screening would be effective in reducing MTCT in a cost-effective manner. A decision-analytic model was constructed to compare two strategies: screening for HIV in the first trimester alone vs addition of repeat screening in the third trimester. Probabilities, costs, and utilities were derived from the literature and varied in sensitivity analyses. The assumed incidence of HIV in pregnancy was 0.029%. Outcomes included costs (in 2022 USD), maternal and neonatal quality-adjusted life years (QALYs), and cases of neonatal HIV. Our theoretical cohort contained 3.8 million pregnant individuals, the approximate number of births in the US in 2020. The willingness to pay threshold was set at $100,000/QALY. We performed tornado analysis and univariable sensitivity analyses to determine inputs that most impacted the model. Universal third trimester screening prevented 209 cases of neonatal HIV in this theoretical cohort. Universal third trimester screening led to an increased cost of $600.7 million and 6,118 increased QALYs, with an incremental cost-effectiveness ratio (ICER) of $98,188.82/QALY, less than the WTP threshold. In a univariate sensitivity analysis, third trimester screening remained cost-effective with variation of HIV incidence in pregnancy to as low as 0.027%. In a theoretical US-based cohort of pregnant individuals, universal repeat screening for HIV in the third trimester was found to be both cost-effective and to reduce vertical transmission of HIV. These results merit consideration of a broader HIV screening program in the third trimester.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Non-alcoholic fatty liver disease screening in type 2 diabetes mellitus: A cost-effectiveness and price threshold analysis

The cost-effectiveness of screening asymptomatic non-alcoholic fatty liver disease (NAFLD) patients remains debatable, with current studies assuming lifelong benefits of NAFLD screening while neglecting cardiovascular outcomes. This study aims to assess the cost-effectiveness of NAFLD screening among type 2 diabetes mellitus (T2DM) patients, and to establish a price threshold for NAFLD treatment, when it becomes available. A Markov model was constructed comparing 4 screening strategies (versus no screening) to identify NAFLD with advanced fibrosis among T2DM patients: fibrosis-4 (FIB-4), vibration-controlled transient elastography (VCTE), FIB-4 and VCTE (simultaneous), and FIB-4 and VCTE (sequential). Sensitivity analyses and price threshold analyses were performed to assess parameter uncertainties in the results. VCTE was the most cost-effective NAFLD screening strategy (USD24,727/quality-adjusted life year [QALY]), followed by FIB-4 (USD36,800/QALY), when compared to no screening. Probabilistic sensitivity analysis revealed a higher degree of certainty for VCTE as a cost-effective strategy compared to FIB-4 (90.7% versus 73.2%). The duration of expected screening benefit is the most influential variable based on incremental cost-effectiveness ratio tornado analysis. The minimum duration of screening benefit for NAFLD screening to be cost-effective was at least 2.6 years. The annual cost of NAFLD treatment should be less than USD751 for NAFLD screening to be cost-effective. Both VCTE and FIB-4 are cost-effective NAFLD screening strategies among T2DM patients in Singapore. However, given the lack of access to VCTE at primacy care and potential budget constraints, FIB-4 can also be considered for NAFLD screening among T2DM patients in Singapore.

Power-assisted Liposuction for Lymphedema: A Cost-utility Analysis.

Extremity volumes from all patients who underwent debulking surgery of the upper extremity at two institutions between December 2017 and January 2020 with at least 12 months follow-up were included. Procedural costs were calculated using Medicare reimbursement data. Average utility scores were obtained for each health state using a visual analog scale, then converted to quality-adjusted life years. A decision tree was generated, and incremental cost-utility ratios were calculated. Sensitivity analyses were performed to evaluate our findings. Debulking surgery is associated with a higher clinical effectiveness (quality-adjusted life year) of 27.05 compared to conservative management (23.34), with a relative cost reduction of $74,487. Rollback analysis favored debulking surgery as the cost-effective option compared to conservative management. The resulting negative incremental cost-utility ratio of -20,115.07 favored debulking surgery and indicated a dominant strategy. Our study supports the use of debulking surgery for the treatment of chronic lymphedema of the upper extremity.

Quantifying the influence of modeling uncertainties on performance evaluation of mega column-core tube-outrigger structure under near-field and far-field ground motions

Different types of ground motions have the potential to aggravate the failure state of mega column-core tube-outrigger structure(MCCTOS) considering uncertainty. It is of great engineering significance to comprehensively analyze the seismic fragility of the structure under different types of ground motions. The purpose of this work is to analyze and predict the impact of modeling uncertainties on the performance evaluation of MCCTOS under different types of ground motions and determine the sensitivity of independent input parameters. On the premise of considering both seismic uncertainty and structural uncertainty, the Latin hypercube sampling and first-order second-moment, which are respectively combined with incremental dynamic analysis, are adopted to perform seismic fragility analyses of MCCTOS. By comparing the fragility curves of MCCTOS under non-pulse near-field ground motions, pulse-type near-field ground motions, and far-field ground motions, the influence of the randomness of earthquakes and structural parameters on the fragility of MCCTOS under different types of ground motions is analyzed. In addition, the seismic damage index is introduced into the fragility assessment of MCCTOS. By combining the seismic damage index with the beta distribution function, the matrix and probability density function of the seismic damage index of MCCTOS are established. Furthermore, the influence of structural parameter uncertainty on the seismic damage index of MCCTOS under different types of ground motions is investigated. The sensitivity analysis of uncertain parameters in the MCCTOS is carried out by using tornado analysis technology and Sobol' method to investigate the influence of the considered parameters on the seismic response of MCCTOS. The results show that pulse-type near-field ground motions are easier to cause structural damage than non-pulse near-field ground motions and far-field ground motions. However, for the MCCTOS under the non-pulse near-field ground motions, the modeling uncertainties have the greatest impact on the seismic capacity and lead to the maximum reduction of the average seismic damage index. The structural responses are found to be most sensitive to the density of concrete, compressive strength of concrete, and structural damping ratio.

Cost-effectiveness analysis of the new oncological drug durvalumab in Italian patients with stage III non-small cell lung cancer.

BackgroundThe monoclonal antibody durvalumab, an immune‐checkpoint inhibitor (ICI) antiprogrammed death ligand 1 (PD‐L1), is available for unresectable stage III NSCLC patients as consolidation therapy following induction chemoradiotherapy, with very promising overall survival (OS) and progression‐free survial (PFS) results in registration trials. The purpose of this study was to provide policymakers with an estimate of the cost‐effectiveness of durvalumab in the treatment of non‐small cell lung cancer (NSCLC).MethodsThe study developed a Markov model covering a 5‐year period to compare costs and outcomes of treating PD‐L1 positive patients with or without durvalumab. We conducted a series of sensitivity analyses (Tornado analysis and Monte Carlo simulation) by varying some parameters to assess the robustness of our model and identify the parameters with the greatest impact on cost‐effectiveness.ResultsPrior to the release of durvalumab, the management of NSCLC over a 5‐year period cost €33 317 per patient, with an average life expectancy of 2.01 years. After the introduction of the drug, this increased to €37 317 per patient, with an average life expectancy of 2.13 years. Treatment with durvalumab led to an incremental cost‐effectiveness ratio (ICER) of €35 526 per year. OS is the variable that contributes the most to the variability of the ICER.ConclusionsThe study observed that durvalumab is a cost‐effective treatment option for patients with unresectable stage III NSCLC.

TORNADO FINANCIAL DEVELOPMENT COST ANALYSIS FOR GREEN PROJECT IN MALAYSIA

In Malaysia, green building has currently become significant as sustainable development. Most of the established developers have incorporated sustainable development in green building projects. Due to the passive evolutionary effects of real estate on the environment and human health, the development and promotion of green buildings for a sustainable environment have become a market trend to attract buyers in this country. Thereby, the qualitative approach methodology is adopted in this study, where a case study has been selected to observe the significant risk impact on the development cost. An in-depth analysis was carried out using a feasibility study, and a discounted cash flow was performed. The simulation runs using tornado analysis to detect the most significant risk affected by development cost. The results indicate that the building cost, mechanical and electrical works, and piling works are the highest risk in developing a green building. Therefore, the client should take extra precautions in green development to monitor the affected cost to minimise project delay and achieve the project objectives. A tornado analysis makes decisionmaking more explicit by the client. It enables the decision-maker to analyse the risk contributing to the development cost and make more effective decisions.

Integrated damage, visual, remote sensing, and environmental analysis of a strong tornado in southern Brazil

On 20 April 2015 a strong tornado struck the city of Xanxerê located in western Santa Catarina (SC) state, in southern Brazil. The tornado destroyed several buildings, causing almost 100 injuries, four fatalities, and R$ 104 million in damage (approximately USD$ 34.6 million according to 2015 dollar quotation), making it one of the most damaging tornadoes in Brazil's history. This study provides an integrated damage, visual, remote sensing, and environmental analysis of the tornado event. Medium-resolution satellite imagery and in situ photographs of the damage show that the tornado caused high-end F2 damage on the Fujita scale across a 4.9-km-long path in the northern portion of Xanxerê. Videos of the tornado and its parent storm reveal the existence of a low-level mesocyclone and rear-flank downdraft, indicating that the storm was a supercell. Horizontal vortices, which are occasionally observed in strong tornadoes but rarely documented in Brazilian tornadoes, were also observed in the videos. The supercell developed in a warm and moist air mass characterized by moderate buoyancy and weak mid-level lapse rates. The mid- and upper-tropospheric forcing for synoptic-scale ascent was weak but the prevailing zonal flow was moderately strong, providing sufficient deep-layer shear for supercell development. A key component of the synoptic-scale environment was the presence of a northerly low-level jet stream that promoted warm moist advection into western SC in addition to increasing the low-level vertical wind shear in the region. On the mesoscale, the presence of a broad cloud shield from a decaying mesoscale convective system (MCS) preceding the supercell formation hampered daytime radiative heating over western SC resulting in low dewpoint depression and, thus, lower lifting condensation levels around Xanxerê. Remote sensing and surface data suggest that the MCS-induced outflow boundary may have been responsible for the initiation of the supercell. The complex subtropical environment of the Xanxerê tornado differs in many aspects from well-documented North American tornadic environments and highlights the need for more studies addressing distinctions between the atmospheric conditions that are conducive to tornadic activity in the two continents.

Cost-Effectiveness Analysis of the Triclip™ Transcatheter Tricuspid Valve Repair System in Patients with Tricuspid Regurgitation.

BackgroundTricuspid regurgitation is a condition that affects 1.6 million patients in the United States and is independently associated with morbidity and mortality. The TriClip™ procedure repairs the tricuspid valve without the need for open-heart surgery. The aim of this study is to evaluate the cost-effectiveness of TriClip™ treatment in patients with advanced tricuspid regurgitation from the Turkish reimbursement agency perspective.MethodsWithin the scope of this study, the general literature was searched in order to reach data on tricuspid regurgitation. The utilization of health care services used in the expert panel was re-calculated with the current reimbursement costs to determine the cost of heart failure in Turkey. In this study, Markov analysis, Tornado analysis, cost-effectiveness analysis, and partitioned survival analysis have been performed to determine whether TriClip™ is an effective treatment method compared to medication treatment. ResultsIn according to calculations, 5-year survival rate was found as 49.91% for medication treatment and 57.64% for TriClip™ treatment. According to the analysis performed, the cost of medication treatment was calculated as €3879.72 and TriClip™ Transcatheter Tricuspid Valve Repair System treatment as €25 661.15 for a 60-month period in patients with tricuspid regurgitation and New York Heart Association III-IV. In the calculation, it was found that TriClip™ treatment gave patients an average of 1.64 life years and it was found to be cost-effective compared to medication treatment.ConclusionsConsidering the positive effect of TriClip™ treatment on patients with tricuspid regurgitation in terms of mortality and regression of the heart failure stage, as recommended in the guidelines, widespread of its use has great importance.

Cost-effectiveness analysis of intensive blood pressure control in Korea.

This study was a cost-effectiveness analysis of intensive blood pressure (BP) control among hypertensive patients in Korea. We constructed a Markov model comparing intensive versus standard BP control treatment and calculated the incremental cost-effectiveness ratio. The study population consisted of hypertensive patients over 50 years old with systolic blood pressures (SBPs) exceeding 140 mmHg and at high risk of cardiovascular disease. Treatment alternatives included lowering the SBP below 120 mmHg (intensive) and 140 mmHg (standard) for target BP. We assumed five scenarios with different medication adherence. The effectiveness variable was quality-adjusted life years (QALYs), and costs included medical costs related to hypertension (HT), complications, and nonmedical costs. In addition, we performed a sensitivity analysis to confirm the robustness of the results of this study. Scenario 5, with 100% medication adherence, showed the lowest incremental cost-effectiveness ratio (ICER) of $1,373 USD, followed by scenario 1 (first 15 years: 62.5%, 16-30 years: 65.2%, after 30 years: 59.5%), scenario 2 (first five years: 62.5% decrease by 5% every five years), and scenario 3 (first 10 years: 62.5% decrease by 10% every 10 years). The ICERs in all scenarios were lower than the willingness to pay (WTP) threshold of $9,492-$32,907 USD in Korea. Tornado analysis showed that the ICERs were changed greatly according to stroke incidence. Intensive treatment of HT prevents cardiovascular disease (CVD); therefore, intensive treatment is more cost-effective than standard treatment despite the consumption of more health resources. ICERs are considerably changed according to medication adherence, confirming the importance of patient adherence to treatment.

Cost analysis of outdoor mandarin and smart farms : Using Monte Carlo simulation

Purpose: This study is to investigate the difference in management costs between smart farms and outdoor mandarin through Monte Carlo simulations. Agriculture is threatened with sustainability due to a decrease in the labor force. In particular, the aging of agriculture in Korea is at a serious level compared to other countries. Smart farms are being distributed to solve the aging problem of agriculture. In particular, IoT, blockchain, machine learning, artificial intelligence, augmented reality, and big data are becoming more common, and such digital agriculture enables sustainable agriculture. such digital agriculture enables sustainable agriculture. So, these technologies often involve uncertainty between technology and technology users. This uncertainty is to be resolved through simulation. Data and methodology: Monte Carlo simulation was performed through Oracle Ball. The outdoor mandarin and the mandarin of the smart farm were set to compare. And the collected data were tornado analysis, spider chart, sensitivity analysis, predictor analysis, and prediction comparison analysis using Oracle balls. Results: As a result of the analysis, In Tornado, pesticide costs, fertilizer costs, and site development cost have a great influence on intermediate goods. however, in sensitivity analysis, pesticide costs, redemption cost for farming facilities, and fertilizer costs have a great influence on intermediate goods. Through the overall analysis, it was analyzed that pesticide and fertilizer costs commonly affect intermediate goods, and pesticide costs affect intermediate goods the most. In the predictive simulation analysis, it was analyzed that there was no significant difference between smart farms and outdoor mandarin of intermediate goods. Conclusion: There is no significant difference between smart farms and outdoor mandarin in terms of management costs. So, Considering the initial facility investment cost of smart farms, it will be difficult to obtain profitability in a short period of time. Pesticide costs have a significant impact on intermediate goods between outdoor mandarin and smart farms, because it was analyzed that there is no significant difference in pesticide costs between outdoor mandarin and smart farm. Currently, smart farms are mainly focused on reducing production costs and reducing labor. But in the future, smart farms need to develop technologies that reduce pesticide costs

Nonlinear Relationship Analysis of Factors Affectiong Intention to Use of Mobile Easy Payment Service

Purpose: This study is to investigate the difference in management costs between smart farms and outdoor mandarin through Monte Carlo simulations. Agriculture is threatened with sustaina0bility due to a decrease in the labor force. In particular, the aging of agriculture in Korea is at a serious level compared to other countries. Smart farms are being distributed to solve the aging problem of agriculture. In particular, IoT, blockchain, machine learning, artificial intelligence, augmented reality, and big data are becoming more common, and such digital agriculture enables sustainable agriculture. such digital agriculture enables sustainable agriculture. So, these technologies often involve uncertainty between technology and technology users. This uncertainty is to be resolved through simulation. Data and methodology: Monte Carlo simulation was performed through Oracle Ball. The outdoor mandarin and the mandarin of the smart farm were set to compare. And the collected data were tornado analysis, spider chart, sensitivity analysis, predictor analysis, and prediction comparison analysis using Oracle balls. Results: As a result of the analysis, In Tornado, pesticide costs, fertilizer costs, and site development cost have a great influence on intermediate goods. however, in sensitivity analysis, pesticide costs, redemption cost for farming facilities, and fertilizer costs have a great influence on intermediate goods. Through the overall analysis, it was analyzed that pesticide and fertilizer costs commonly affect intermediate goods, and pesticide costs affect intermediate goods the most. In the predictive simulation analysis, it was analyzed that there was no significant difference between smart farms and outdoor mandarin of intermediate goods. Conclusion: There is no significant difference between smart farms and outdoor mandarin in terms of management costs. So, Considering the initial facility investment cost of smart farms, it will be difficult to obtain profitability in a short period of time. Pesticide costs have a significant impact on intermediate goods between outdoor mandarin and smart farms, because it was analyzed that there is no significant difference in pesticide costs between outdoor mandarin and smart farm. Currently, smart farms are mainly focused on reducing production costs and reducing labor. But in the future, smart farms need to develop technologies that reduce pesticide costs

Cost-effectiveness analysis of olaparib and niraparib as maintenance therapy for women with recurrent platinum-sensitive ovarian cancer

ABSTRACT Objective We evaluated the cost-effectiveness of olaparib and niraparib as maintenance therapy for patients with platinum-sensitive recurrent ovarian cancer.Methods: A decision analysis model compared the costs and effectiveness of olaparib and niraparib versus placebo for patients with or without germline BRCA mutations. Resource use and associated costs were estimated from the 2020 National Health Insurance Administration reimbursement price list. Clinical effectiveness was measured in progression-free survival per life-years (PFS-LY) based on the results of clinical trials SOLO2/ENHOT-Ov21 and ENGOT-OV16/NOVA. The incremental cost-effectiveness ratio (ICER) was estimated from a single-payer perspective. Results In the base case, olaparib was the more cost-effective treatment regimen. The ICERs for olaparib and niraparib compared to placebo were NT$1,804,785 and NT$2,340,265 per PFS-LY, respectively. Tornado analysis showed that PFS and the total resource use cost of niraparib regimen for patients without gBRCA were the most sensitive parameters impacting the ICER. The ICERs for both drugs in patients with a gBRCA mutation were lower than in patients without a gBRCA mutation. Probabilistic sensitivity analysis indicated that olaparib was more cost-effective than niraparib at the willingness-to-pay threshold of NT$2,602,404 per PFS life-year gained. Conclusion Olaparib was estimated to be less cost and more effective compared to niraparib as maintenance therapy for patients with recurrent platinum-sensitive ovarian cancer.

Cost-Effectiveness in Perioperative Care: Application of Markov Modeling to Pathways of Perioperative Care

ObjectivesThis study aimed to evaluate the application of cost-effectiveness modeling to redesign of perioperative care pathways, from a hospital perspective. MethodsA Markov cost-effectiveness model of patient transition between care locations, each with different characteristics and cost, was developed. Inputs were derived from clinical trials piloting a preoperative call center and a postoperative medium-acuity care unit. The effect chosen was days at home (DAH) after surgery, reflecting quality of in-hospital care, acknowledged financially by fundholders, and relevant to consumers. Cost was from the hospital’s perspective. A model cycle time of 4 hours for 30 days reflected relevant timelines and costs. ResultsA Markov model was successfully created, accounting for the care locations in the 2 pathways as model states and accounting for consequences and costs. Cost-effectiveness analysis allowed the calculation of an incremental cost-effectiveness ratio comparing these pathways, providing a mean incremental cost-effectiveness ratio of −$427 per additional DAH, where incremental costs and DAH were −$644 and +1.51, respectively. Probabilistic sensitivity analysis suggested the new pathway had a 61% probability of reduced costs and a 74% probability of increased DAH and a 58% probability this pathway was dominant. Tornado analysis revealed the major contributor to increased costs as intensive care unit stay and the major contributor to decreased costs as ward stay. For the new pathway, the probability of transfer from ward to home and the probability of staying at home had the greatest impact on DAH. ConclusionsThese data suggest Markov modeling may be a useful tool for the cost-effectiveness analysis of initiatives in perioperative care.

An analysis of tornado warning reception and response across time: leveraging respondent's confidence and a nocturnal tornado climatology

AbstractNocturnal tornadoes are challenging to forecast and even more challenging to communicate. Numerous studies have evaluated the forecasting challenges, but fewer have investigated when and where these events pose the greatest communication challenges. This study seeks to evaluate variation in confidence among US residents in receiving and responding to tornado warnings by hour-of-day. Survey experiment data comes from the Severe Weather and Society Survey, an annual survey of US adults. Results indicate that respondents are less confident about receiving warnings overnight, specifically in the early morning hours (12 AM to 4 AM local time). We then use the survey results to inform an analysis of hourly tornado climatology data. We evaluate where nocturnal tornadoes are most likely to occur during the time frame when residents are least confident in their ability to receive tornado warnings. Results show that the Southeast experiences the highest number of nocturnal tornadoes during the time period of lowest confidence, as well as the largest proportion of tornadoes in that time frame. Finally, we estimate and assess two multiple linear regression models to identify individual characteristics that may influence a respondent’s confidence in receiving a tornado between 12 AM and 4 AM. These results indicate that age, race, weather awareness, weather sources, and the proportion of nocturnal tornadoes in the local area relate to warning reception confidence. The results of this study should help inform policymakers and practitioners about the populations at greatest risk for challenges associated with nocturnal tornadoes. Discussion focuses on developing more effective communication strategies, particularly for diverse and vulnerable populations.