Reduction Of Expenses Research Articles

Applied Economic Engineering To Solar Energy Projects

Background: The search for the use of electrical energy through renewable sources is experiencing significant expansion, particularly at a time when social policies are being implemented with a focus on climate conditions. Solar energy stands out as a renewable energy source with costs that are more accessible than conventional energy sources. Photovoltaic panels for commercial use represent a smart strategy for many companies seeking energy efficiency, cost savings, and sustainability. These systems offer benefits that range from reductions in operational expenses to contributions toward corporate social responsibility goals. Materials and Methods: To conduct this study, two research methods were used: bibliographic research and documentary research. The qualitative approach employed in this article enabled a detailed investment analysis of the elements related to economic engineering applied to solar energy projects. Techniques for economic and financial viability were presented, including Net Present Value (NPV), Internal Rate of Return (IRR), and Payback Period. Results: The findings of the research demonstrated that solar energy is a viable and strategic option for economic growth in Ceará. Considering that Ceará ranks fifth in Brazil for its capacity to generate solar energy, solar power represents a promising investment alternative for the state. The study highlighted the economic and environmental advantages of utilizing solar energy. Conclusion: The research clearly shows that solar energy not only contributes to economic growth but also plays a crucial role in environmental conservation in Ceará. Achieving the objectives reinforces the importance of government policies focused on expanding clean energy sources. These policies will ensure that the benefits of solar energy extend beyond the current scenario, fostering a more sustainable and inclusive future.

Women’s Leadership in Sustainable Agriculture: Preserving Traditional Knowledge Through Home Gardens in Santa Maria Jacatepec, Oaxaca

Rural communities in Oaxaca face challenges such as food insecurity, economic instability, and the loss of traditional agricultural knowledge. Home gardens, once essential for food production and income generation, have declined due to migration, environmental degradation, and modern agricultural pressures. This study evaluated how community-driven models, supported by crowdfunding, can revitalize home gardens to improve food security, build community resilience, and promote economic empowerment. A mixed-methods approach, including household surveys, interviews, and focus groups, was used to assess the impact of these gardens. The results showed that over 70% of households experienced improved food security and reduced reliance on external food sources. Home garden production also led to a 20% reduction in food expenses, and the sale of surplus crops provided additional income, enhancing household economic stability. Women’s involvement in agricultural decision-making increased, fostering empowerment within both family and community contexts. Traditional practices, such as seed saving and organic pest control, were maintained, contributing to the ecological sustainability of the gardens. Crowdfunding was an effective tool for financing home gardens, boosting community engagement and strengthening social bonds. The findings highlight the potential of integrating traditional knowledge with modern funding strategies to create resilient, sustainable agricultural systems in rural Oaxaca.

Sustainable bridge engineering: Cost reduction and durability enhancement in developing nations

This paper explores innovative approaches to sustainable bridge engineering, focusing on cost reduction and durability enhancement in developing nations. Drawing from my successful projects in Uganda and Guinea, where I reduced construction costs by 30% without compromising structural integrity, I will present detailed case studies that highlight the effective application of sustainable materials and techniques. In Uganda, through the use of locally sourced materials and optimized construction processes, I achieved significant cost savings while ensuring long-term durability in rural infrastructure. Similarly, in Guinea, I implemented advanced engineering practices that prioritized resource efficiency, leading to a reduction in project expenses and a strengthened bridge lifespan. The case studies demonstrate how sustainable engineering practices can be tailored to local conditions and still meet global standards for resilient infrastructure. By emphasizing cost-effective materials such as recycled aggregates and low-carbon concrete, and employing techniques such as modular construction and innovative foundation designs, my work offers a blueprint for reducing expenses while enhancing the longevity of infrastructure. The strategies I employed in Uganda and Guinea are adaptable to other developing nations and can be applied globally, including in the U.S., to build durable and sustainable bridges that address both budgetary constraints and environmental considerations. This paper aligns with the broader goals of sustainable infrastructure development by contributing to the global discourse on resource-efficient engineering solutions. The findings support national and international objectives to enhance infrastructure resilience while minimizing environmental impact and construction costs.

ARTIFICIAL INTELLIGENCE FOR OPTIMIZED WELL CONTROL AND MANAGEMENT IN SUBSURFACE MODELS WITH UNPREDICTABLE GEOLOGY

A comprehensive control policy structure utilizing Artificial Intelligence (AI) is presented for closed-loop management in subsurface models. Conventional Closed-Loop Optimisation (CLO) approaches entail the iterative implementation of information assimilation, past synchronization details, and effective optimizing procedures. Information assimilation is more difficult when there is uncertainty in the geological approach and the specific model conclusions. Closed-Loop Reservoir Monitoring (CLRM) offers a control strategy that promptly correlates flow information obtained from wells, as typically accessible, to appropriate well stress configurations. The rule is characterized by time-based compression and gate-based converter sections. Learning is conducted during a preprocessing phase utilizing geological modeling derived from various geological settings. Illustrative instances of oil extraction using water insertion, utilizing both 2 and 3-dimensional geological designs, are shown. The AI-oriented technique demonstrates a 17.2% increase in Net Present Value (NPV) for 2D instances, an additional 31.5% for 3D cases compared to the effective optimization of previous models, and a 1-6.5% enhancement in NPV relative to standard CLRM. Based on the methods and variable configurations examined in this study, the controlling policy method yields a 71.34% reduction in processing expenses compared to conventional CLRM.

Antimicrobial stewardship program in one primary care hospital, a snapshot analysis

Abstract Antimicrobic resistance (AMR) continues to rise, whereas development of new agents to counter it has slowed. A heightened need to maintain the effectiveness of currently available agents exists. Healthcare-associated infections (HAIs) are a significant cause of poor treatment outcomes and elevated healthcare and societal costs worldwide. At the beginning of 2024, we started a prospective, interventional, interrupted time-series study, based on Prospective Audit and Feedback in the Intensive Care Unit (ICU) and in the internal medicine ward of our hospital. The primary outcomes will be the difference in the antibiotic consumption, and the incidence of bloodstream infections (BSI) caused by multidrug-resistant (MDR) organisms. The secondary outcomes will include the hospital mortality rate, the mean length of stay and the antibiotic expense. We conducted a snapshot analysis of the first three months to assess the efficacy our program. In the first three months we registered a global reduction in antibiotic expense (almost by half in comparison of 2023 first quarter) and consumption, particularly in the use of carbapenems: (change in level, CL: -51,26 DDD/1000 PD,) and third- generation cephalosporins (CL: -6 DDD/1000 PD). We registered a reduction in the use of hydroalcoholic gel, probably due to the reducted perception after the waning of risk perception towards Covid-19, although no big difference was observed in BSI incidence due to MDR Gram-negative organisms (CL: +1,2 events/1000 PD). Albeit partial, once again these findings demonstrated that implementation of an antimicrobial stewardship program, no matter the level of healthcare, is critical for fighting the AMR and to lessen the burden on Public Health; in particular our program induced a significant reduction in antibiotic consumption that lead to more funds at disposal to improve our clinical practice. Key messages • Once again our findings demonstrated that implementation of an antimicrobial stewardship, no matter the level of healthcare, is critical for fighting the AMR. • Our program induced a significant reduction in antibiotic consumption.

Enhancing financial management in healthcare: The impact of Activity-Based Costing and Time-Driven Activity-Based Costing methodologies in Kordan's private sector in Jordan

This study examines the effectiveness of implementing Activity-Based Costing (ABC) and Time-Driven Activity-Based Costing (TDABC) in Jordan’s private healthcare sector focusing on managing costs while maintaining quality care. A descriptive and analytical approach was adopted involving 213 individuals working in the financial affairs departments of private hospitals in Amman representing various types of institutions. The key variables of interest were the accuracy of cost measurement, expense reduction, cost allocation and various cost management approaches. The main findings indicate that implementing ABC and TDABC significantly improved cost management and cost reduction within these institutions. These systems have been effective in enhancing the accuracy of cost measurement, improving profitability, reducing unnecessary expenses, and achieving better cost allocation, thereby leading to better financial stewardship. This study underscores the critical importance of integrating these systems into healthcare financial frameworks. Moreover, it highlights the need for further training for financial managers and accountants to fully leverage these approaches and contribute to ongoing improvements in healthcare financial management. Additionally, this research presents empirical evidence from an underrepresented region where no prior studies have been conducted, thereby contributing to the existing body of knowledge and offering valuable insights for future initiatives in Jordan. The study also provides useful guidance for implementing these cost-management approaches more broadly in other regions and countries.

Multidisciplinary Design Optimization of Alignment and Whirling Vibration Characteristics of a Submarine Propulsion Shafting Using Kriging Surrogate Model

To improve the performance indexes, such as safety, reliability and acoustic stealth, of a submarine, it is significant to optimize the dynamic characteristics of its propulsion shafting. The alignment state of a shafting has a coupling effect on its whirling vibration characteristics, and the multidisciplinary design optimization (MDO) theory can fully consider the coupling relationships between different disciplines like this, which is a scientific and effective method to achieve the design optimization of shafting dynamics. However, the iterative calculation of high-precision numerical models greatly restricts the optimization efficiency of this method. Aiming at this problem, in this paper, an MDO model was established based on the coupling dynamic analysis of submarine propulsion shafting, and the Kriging surrogate model was used to predict the state variables within each subdiscipline. Along with the reduction of computational expense, the MDO of the alignment and whirling vibration characteristics of the shafting was achieved. The studied results can be applied to the design process of submarine propulsion shafting, which can provide technical and theoretical support for improving the optimization efficiency of its coupling dynamics.

A new approach for optimal design of intensive care unit

Planning and budgeting for healthcare facilities necessitate precise estimation and a thoughtful analysis of the required area for each department, as well as extensive knowledge of the most important elements that can influence the design and provide an appropriate environment for staff and patients. A gross conversion factor is influential in calculating the entire area of a department. However, there is no precise standard indicating how this factor should be calculated. To address this problem, quality function deployment (QFD) has been implemented. The intensive care unit (ICU) is one of the highly equipped departments that should be properly planned; therefore, it was selected for application. The five steps of the QFD are used to identify and rank the most important and efficient design features. Only the top factors are considered in calculating the required area for the ICU department. This approach presents a unique method for estimating the gross square area based on calculating the gross conversion factor. To demonstrate the proposed approach’s efficacy, it was applied to two Egyptian public hospitals. The results reveal that 15–16% of the total space of both hospitals can be reduced from the total department space. Moreover, an outstanding reduction in ICU design and preparation expenses has been achieved. The design reduces the required budget for a project while maintaining the same construction material quality and accommodating extra beds. Additionally, the QFD proves its ability to redesign the ICU department while reducing costs.

International Transportation Infrastructure and China Enterprises Green Innovation: Evidence from the China Railway Express

The China Railway Express (CRExpress) is a vital international transportation infrastructure for the advancement of the Belt and Road Initiative and the expansion of international commerce, providing a significant opportunity for Chinese companies to undergo a sustainable transformation. We use a multi-period differences-in-differences model to investigate the relationship and mechanism between the opening of the CRExpress and green innovation of enterprises, based on the panel data of Chinese A-shared listed companies from 2007 to 2020. The results show that the opening of the CRExpress can significantly increase the logarithmic number of green patent applications by at least 5% in enterprises with a spoke radius of 250–450 km, and it also has a significant positive effect on different types of green patents to varying degrees. By examining the sub-items of ESG ratings, the opening of the CRExpress can promote the green innovation of enterprises through the improvement of E-score. Additionally, three pivotal mechanism pathways have been identified: the promotion of regional economic development, the alleviation of corporate financing constraints, and the reduction of corporate logistics expenses. Furthermore, we find that the effect of the CRExpress turns out larger on the green innovation of enterprises in the Secondary Industry and the Tertiary Industry, manufacturing industry, state-owned enterprises, and firms located in the eastern and central regions. Based on the empirical study, we provide policy implications for deepening the correlation between the CRExpress and green innovation.

Agroecological aspects of nutrients absorption by industrial crops in the conditions of Odesa Region

Modern agroindustrial activities that are focused on intensive methods of agricultural production require a deep understanding of the processes occurring in agroecosystems. Odesa Region is characterised by specific agroclimatic conditions and soil cover features making the study of this issue higly relevant. Intensive use of industrial crops requires knowledge about absorption and removal of biogenic elements such as nitrogen, phosphorus, and potassium. The importance of this research is determined by the need to reveal the dynamics of biogenic elements absorption by industrial crops in the conditions of Odesa Region, taking into account its agroclimatic and soil characteristics. The results of this research are intended to contribute to development of scientifically grounded recommendations for farmers and agricultural enterprises regarding effective management of agroecosystems. This will not only increase productivity of industrial crops but also ensure environmental sustainability of agricultural practices. Identifying the optimal conditions for absorption and removal of biogenic elements will contribute to improvement of soil fertility and preservation of its productivity in a long-term perspective. The conclusions and recommendations obtained during the research can be used to improve agronomic practices, reduce environmental impact, and increase efficiency of agricultural production. Considering current trends of agricultural development, it is necessary to pay special attention to optimization of agrotechnical measures allowing reduction of expenses for fertilizers and improvement of their efficiency. Introduction of new technologies is another important aspect to be considered. It will allow more precise determination of plants' nutrient needs and help to provide them with nutrients according to their growth phases. In addition, it is necessary to consider the interaction between different nutrient elements that can affect their availability and plants' ability to assimilate them.

Influence of Hospice Palliative Care on Medical Service Usage in Prolonged Mechanical Ventilation Cases: A Nationwide Cohort Study.

Numerous studies have demonstrated that hospice palliative care interventions for cancer patients can reduce health care utilzation. In Taiwan, 20-25% of patients who require mechanical ventilation are using prolonged mechanical ventilation (PMV); however, only a limited number of studies have addressed the effectiveness of hospice palliative care for these patients. This study investigated the impact of hospice palliative care utilization on medical utilization among subjects using PMV. By using the health insurance database of a nationwide population-based study, we identified subjects who had been on mechanical ventilation for > 21 d, were age ≥18 y between 2009 and 2017, and had received hospice palliative care. The control group was formed through 1:1 matching by using propensity scoring after excluding patients who had participated in palliative care for <15 d or for >181 d. Furthermore, we used a conditional logistic regression analysis to investigate the incidence of ICU admission, emergency department presentation, and cardiopulmonary resuscitation within 14 d before death. A total of 186,533 new subjects receiving PMV age ≥ 18 y were admitted between 2009 and 2017. In addition, the number of subjects receiving palliative care increased annually, rising from 0.6% in 2009 to 41.33% in 2017. The emergency department visits (odds ratio [OR] 0.68, 95% CI 0.63-0.74), ICU admission (OR 0.59, 95% CI 0.53-0.66), cardiopulmonary resuscitation (OR 0.40, 95% CI 0.35-0.46), and total hospitalization cost ($1,319.91 ± $1,821.66 versus $1,544.37 ± $2,309.27 [$USD], P < .001) were significant lower in the palliative care group. Subjects undergoing PMV while receiving hospice palliative care experienced significant reductions in total hospitalization costs, ICU admissions, cardiopulmonary resuscitation, and medical expenses within 14 d before death.

Efficiency of Inventory in Thai Hospitals: Comparing Traditional and Vendor-Managed Inventory Systems

Background: Traditional procurement and price negotiation methods in public hospitals in Thailand involve group purchasing agreements and bulk orders, posing challenges to improving inventory management efficiency. The vendor-managed inventory (VMI) model is a promising alternative for enhancing hospital performance, especially during crises. This study aimed to assess the potential cost savings in implementing VMI in a large general hospital in Thailand. Methods: A simulation modeling approach was used to compare the current inventory system with three VMI models: VMI1, focused on improving inventory turnover rate (ITR); VMI2, emphasized frequent replenishment with a 1-month supply; and VMI3, eliminated safety stock. Results: The results demonstrated significant cost savings, with potential reductions in total inventory management expenses. Specifically, VMI1 improved ITR from 6.31 to 7.76, reducing average inventory by 36% and cutting management costs by 40%. VMI2, with an ITR of 12.80, reduced inventory by 44% and saved 47% in management costs, while VMI3 achieved a 70% reduction in inventory and a 69% saving in management costs. Conclusions: This study highlights the VMI’s transformative potential in hospital inventory management, demonstrating significant cost savings. However, in the public sector, the feasibility of procurement regulations requires further exploration.

FP1.5 - Safety and efficacy of Ambulatory treatment of uncomplicated acute diverticulitis: A two-centre cohort study and a proposal of an Ambulatory pathway

Abstract Aim This study aimed to assess the safety and efficacy of ambulatory treatment in patients with uncomplicated acute diverticulitis (AD) compared with inpatient treatment. Methods This is a retrospective comparative study conducted in two hospitals. All patients presented to the emergency department with CT-confirmed Hichney 1a AD during the period from 01/01/2022 to 31/12/2022 were included in this study. Patients with complicated diverticulitis or CT was not performed were excluded. All patients were followed for 12 months for re-admission and AD recurrence. Data analysis was performed with SPSS 27. Results A total of 137 patients were presented during the study period with CT-confirmed Hinchey 1a AD. The median age was 62 (24-94) years old, with a female-to-male ratio of 1.7:1. In the majority of patients (75.9%), WBCS was &amp;lt; 15 and CRP &amp;lt; 100. Moreover, 37.2% had previous AD, and it was complicated in 5.8%. For 12 months of follow-up, 19% of the cases developed diverticulitis recurrence. However, only 1 patient required surgery, and no patient required radiology intervention. No mortality was reported. A luminal investigation (CT colonoscopy or endoscopy) was organized in 61.3%, and colon cancer was detected in one patient. A comparison of patients who were treated as ambulatory (n=35) versus inpatient (n= 102) showed no significant difference regarding re-admission and recurrence of AD (P= 0.22) and surgical intervention (P=0.5) during 1-year follow-up. Conclusion With comparable results to inpatient treatment, the Ambulatory treatment of Hinchey 1a AD is safe and feasible and provides a reduction of treatment expenses.

Can formal home and community-based care substitute informal care? Evidence from Chinese Longitudinal Healthy Longevity Survey

BackgroundFormal home and community-based care are often considered as the preferable option to institutional care, offering older individuals the convenience of receiving care in their homes. Although research has found that these services may alleviate the burden on informal caregivers, there is a lack of research on which specific types of formal home and community-based care influence informal care provision.MethodsEmploying fixed-effects and quantile regression models, this study seeks to explore the effects that various formal home and community-based care services have on reducing the burden of informal care. This study draws data from the Chinese Longitudinal Healthy Longevity Survey 2005, 2008, 2011, 2014, and 2018.ResultsOur findings indicate that two types of formal care substantially influence the provision of informal care. The availability of daily living assistance services correlates with reduced informal caregiving hours, especially for those with extensive care needs. The availability of community-based health care services is linked to a reduction in the direct expenses incurred from informal caregiving, especially for those incurring greater direct caregiving costs. These effects are more prominent among urban residents. Other services, such as mental health support and legal advice services, do not demonstrate significant effects on reducing informal care hours and costs.ConclusionsDaily living assistance and community-based health care services play a crucial role in benefiting informal caregivers. It is important to prioritize the expansion of these services, especially among those with greater care needs.

Optimizing energy consumption in smart buildings: A model for efficient energy management and renewable integration

In the current landscape of sustainable energy, integrating photovoltaic (PV) generation and electric vehicles (EVs) into household energy management systems (EMSs) has become a pivotal strategy to enhance grid sustainability in residential areas and provide economic benefits to homeowners. This article introduces an innovative approach to an energy administration framework designed for intelligent households, to seamlessly integrate EVs, both with and without PV generation. The proposed plan meticulously optimizes residential electricity expenses. It standardizes the load gradient using Time-of-Use (TOU) cost, residential electricity use fluctuations, PV generation patterns, and specific variables of EVs, including entry and exit times and charging statuses. The management method is divided into two distinct phases based on charging constraints and initial charge status. Stage A comprises three operational states contingent upon the availability of PV generation, while Stage B involves five operational states predicted based on anticipated PV generation. Through this research, the advanced control strategy facilitates precise adjustment of energy absorption by EVs from the grid and/or PV generation, along with injected energy derived from EVs to the grid. It ensures minimal residential electricity expenses and synchronizes the electrical load profiles. The findings indicate a significant reduction in residential electricity expenses and a substantial normalization of power load characteristics. Furthermore, simulation results emphasize the superior performance of the proposed plan for intelligent households fitted with both EVs and PV generation, compared to households with EVs alone, in terms of lowering expenses and normalizing load scenarios.

Carrot or stick? Environmental and welfare implications of sustainable aviation fuel policies

Sustainable aviation fuel (SAF) serves as a critical short-term measure for reducing aviation's carbon footprint. Two main policy tools, subsidy and quota, have been developed to support its usage. We build an economic model to compare the environmental and welfare impacts of these two policies. First, we find that if an airline uses the same portion of SAF under both policies, the subsidy approach results in reduced SAF costs, augmented airline output, and heightened emissions. Second, the subsidy policy is better than the quota policy in terms of consumer surplus, airline profits, SAF blender profit, and social welfare, if the traditional aviation fuel is sufficiently inexpensive and the emission regulation under the subsidy policy is adequately stringent. Finally, to demonstrate the empirical relevance of our theoretical framework, we have employed empirically-validated parameters for model calibration. Sensitivity analysis indicates that SAF production costs and market potential are pivotal factors influencing governmental policy formulation. With the reduction in SAF production expenses and the growth of the aviation sector, the government is positioned to adopt a more aggressive policy stance, characterized by higher SAF quotas and increased subsidies, to stimulate the uptake of SAF by airlines.

Review of Data-Driven Models in Wind Energy: Demonstration of Blade Twist Optimization Based on Aerodynamic Loads

With the increasing use of data-driven modeling methods, new approaches to complex problems in the field of wind energy can be addressed. Topics reviewed through the literature include wake modeling, performance monitoring and controls applications, condition monitoring and fault detection, and other data-driven research. The literature shows the advantages of data-driven methods: a reduction in computational expense or complexity, particularly in the cases of wake modeling and controls, as well as various data-driven methodologies’ aptitudes for predictive modeling and classification, as in the cases of fault detection and diagnosis. Significant work exists for fault detection, while less work is found for controls applications. A methodology for creating data-driven wind turbine models for arbitrary performance parameters is proposed. Results are presented utilizing the methodology to create wind turbine models relating active adaptive twist to steady-state rotor thrust as a performance parameter of interest. Resulting models are evaluated by comparing root-mean-square-error (RMSE) on both the training and validation datasets, with Gaussian process regression (GPR), deemed an accurate model for this application. The resulting model undergoes particle swarm optimization to determine the optimal aerostructure twist shape at a given wind speed with respect to the modeled performance parameter, aerodynamic thrust load. The optimization process shows an improvement of 3.15% in thrust loading for the 10 MW reference turbine, and 2.66% for the 15 MW reference turbine.

A polifarmáciás idős betegek gyógyszerészi gondozásának gazdasági előnyei

The danger of polypharmacy (polypragmasia) lies in the fact that it usually affects older people who suffer from several chronic diseases and who are also less likely to medication adherence. For this reason, it is important to follow the drug therapy of these patients in the pharmacies, where feedback to general practitioners and specialists can take place in the event of a problem. For this reason, the development of pharmaceutical care is crucial. In the case of polypharmacy patients, inadequate drug therapy greatly increases the development of adverse drug effects and thus may increase mortality and morbidity indicators. Knowing the facts, it can be said that although pharmaceutical care involves additional costs, the adverse drug effects filtered out by it mean reduction in expenses.

Modeling impact of inflation reduction act price negotiations on new drug pipeline considering differential contributions of large and small biopharmaceutical companies.

Provisions of the Inflation Reduction Act mandating drug price negotiation by the Centers for Medicare & Medicaid Services have been criticized as a threat to pharmaceutical innovation. This study models potential impacts of the Inflation Reduction Act on drug approvals based on the differential contributions of large pharmaceutical companies and smaller biotechnology firms to clinical trials and the availability of capital. This study examined research and development expense, revenue, and new investment (sale of common and preferred stock) by public biopharmaceutical companies and sponsorship of phased clinical trials in ClinicalTrials.gov. Financial data were incorporated in a model that estimates the number of drugs in each phase and approvals from reported phase-specific costs and transition rates, proportional sponsorship of trials by companies of different size, projected reductions in research and development spending based on company size, and three scenarios by which large companies may allocate reductions in research and development spending among clinical phases: (1) research and development proportionally reduced across phases; (2) research and development disproportionally reduced in phases 2-3; and (3) research and development disproportionately reduced in phases 1-2. Financial data were examined for 1378 public biopharmaceutical companies (2000-2018). Research and development expense was associated with revenue for 79 large companies with market capitalization ≥$7 billion with a 10% reduction in revenue reducing research and development expense by 8.4%. For 1299 smaller companies with market capitalization <$7 billion, research and development was associated with new investment, but not revenue. Smaller companies sponsored 55.2% of phase 1, 55.6% of phase 2, and 49.8% of phase 3 trials in ClinicalTrials.gov 2013-2018. In a model of clinical development that apportions clinical trials between large and smaller companies and determines the number of trials based on research and development resources, 400 drugs entering development produced 47.3 approvals (11.83% rate). A 10% reduction in revenue, reflecting the upper boundary of observed changes 2000-2018, with (1) proportional reduction across phases 1-3 produced 45.1 approvals (4.61% reduction); (2) disproportional reduction of phases 2-3 produced 42.8 approvals (9.55% reduction); and (3) disproportional reduction of phases 1-2 produced 46.9 approvals (0.95% reduction). This work suggests that the drug price negotiation provisions of the Inflation Reduction Act could have little or no impact on the number of drug approvals. While large pharmaceutical companies may reduce research and development spending, continued research and development by smaller companies and strategic allocation of research and development resources by large companies may mitigate any negative effects of the Inflation Reduction Act.

“What Do They Say in Mosques? Islamic Discourse on Limiting Ritual Expenses”

This article examines the changes in religious policy, Islamic beliefs, religious life, national values, and family rituals in Uzbekistan during the years of independence. Particularly, it analyzes a series of fatwas, guidelines, and theses on Friday prayer topics published by the Office of Muslims of Uzbekistan in recent years. The author substantiates the amalgamation of religious and national perspectives in Uzbek family rituals, encompassing childbirth, marriage, and mourning ceremonies, drawing on ethnographic materials. Furthermore, it delves into the views of Islamic scholars and imams concerning the reduction of specific expenses and extravagances in these rituals, citing examples from Friday prayers and various social networks. Through anthropological observations of modern Uzbek society, including Muslims' public activities, Friday prayers, neighborhoods, and community events, as well as through various TV talk shows and radio broadcasts, the article explores "Aqiqa" ceremonies, circumcision weddings, marriages, and mourning rituals conducted by Uzbek imams in matters of family and marriage. The author highlights the discussions of "Amru Ma'ruf" topics during ceremonies, widely debated on mosque websites, imams' pages, and social media platforms (Telegram, Facebook, Instagram). The article underscores the impact of Islamic scholars' and imams' ongoing efforts, noting changes in the balance of expenses in the ceremonial life of the Uzbek people, particularly evident in marriage ceremonies. Moreover, it analyzes changes and transformative processes in Uzbek family rituals from the perspective of ritual economy.