Terms Of Productivity Losses Research Articles

New Hybrid MCDM Approach for an Optimal Selection of Maintenance Strategies: Results of a Case Study

Summary Industrial systems are becoming more sophisticated, and their failure can result in significant losses for the company in terms of production loss, maintenance costs, fines, image loss, etc. Conventional approaches to modeling and evaluating the failure mechanisms of these systems do not consider certain important aspects, such as the interdependencies between failure modes (FMs) with information and data containing uncertainties as they are generally collected from experts’ judgments. These restrictions may lead to improper decision-making. The use of more advanced techniques to model and assess the interdependencies among components’ failures under uncertainties seems to be more than necessary to overcome these deficiencies. It is in this context that the proposed approach fits. It consists of proposing a hybrid multicriteria decision-aking (MCDM) approach that combines several techniques for a better selection of maintenance strategies. Using the failure mode and effects analysis (FMEA) technique, the potential FMs of components, along with their causes and effects, are identified. The relative importance (or weight) of these FMs is determined using the fuzzy simple additive weighing (FSAW) method based on how they affect the system’s goals. The causal relationships between FMs and their final weights are determined by the fuzzy cognitive maps (FCM) method and the nonlinear Hebbian learning and differential evolution (NHL-DE) algorithm. Finally, based on the final FM weights provided by the FCM, the simple additive weighing (SAW) method is used to select the optimal maintenance strategies. The results of applying the proposed approach to an operating compressor lubrication and sealing oil system demonstrate its importance and usefulness in assisting system operators to efficiently allocate the optimal maintenance strategies, considering the strong correlation between FMs and their effects on system performance while accounting for the uncertainties associated with experts’ judgments. These correlation effects have led to changes in the assigned weights of the selected FMs. Specifically, the FM related to the low output of the lube/seal oil pump, which was initially assigned a lower priority, and with the correlation effects has become the first critical FM. This shift in prioritization emphasizes the need to address this particular FM promptly. By focusing on addressing these high-priority FMs, maintenance efforts can be optimized to prevent or mitigate more severe consequences. Among the various maintenance strategies evaluated, it was determined that the combination of condition-based maintenance (CBM) and precision maintenance (PrM) yields the most favorable outcome in terms of mitigating the impact of accidental failures and undesired events on the selected system.

Commentary on Brennan et al.: Pros and cons of minimum unit price for alcohol.

Commentary on Brennan et al.: Pros and cons of minimum unit price for alcohol.

Epidemiological, clinico-diagnostic and therapeutic aspects of bovine respiratory disease in Indian buffaloes

Bovine Respiratory Disease (BRD) is major health problem occurring worldwide in bovines, responsible for high morbidity and mortality in calves and heavy economic losses in terms of production losses in milch animals and cost of veterinary treatment. Hence the present study was planned to investigate epidemiological, clinico-diagnostic and therapeutic aspects of BRD in Indian buffaloes. A total of 805 buffaloes reported to TVCC, COVAS, Udgir during the study period were screened for Bovine respiratory disease. On the basis of history of varying degree of nasal discharge, coughing, dyspnoea and abnormal lung sounds, 37 buffaloes were found positive for BRD, indicating 4.60% overall prevalence. The haemoanalysis showed significant (P<0.01) leukocytosis associated with neutrophilia. The radiographic examination of thorax revealed variable degree of congestion and diffuse consolidation of lungs. The bacteria isolated from nasal swabs were Staphylococcus sp., Streptococcus sp., E. coli, Corynebacterium sp., Klebsiella sp., Manheimia haemolytica, Brevundimonas sp. and Pseudomonas sp. Antibiogram of pure culture organisms isolated from BRD affected buffaloes revealed highest sensitivity for gentamicin (83.33%), followed by enrofloxacin (58.33%), ceftiofur sodium (50.00%), moxifloxacin (33.33%). Thirty-one BRD affected buffaloes were randomly distributed in four groups and treated with gentamicin 4 mg/ kg, enrofloxacin 5 mg/kg, moxifloxacin 5 mg/kg and ceftiofur 1.6 mg/kg respectively. All treated buffaloes from different groups clinically cured within 5 to 15 days. Based on results of current therapeutic trial, gentamicin proved most effective and economic in treatment of BRD in buffaloes.

Cost-Benefit Analysis of Interventions to Mitigate the Monkeypox Virus.

When a viral outbreak occurs, governments are obligated to protect their citizens from the diverse adverse effects of the disease. Health policymakers often have several interventions to consider based on the health of the population, as well as the cascading social and economic consequences of the possible mitigation strategies. The current outbreak of the monkeypox virus has elicited debate on the best mitigation strategy, especially given that most world economies are still recovering from the harsh economic effects of the COVID-19 pandemic. This paper sought to analyze the costs and benefits of three possible strategies and determine which option has the best health outcomes and positive economic effects. A case study of Jeddah was performed, whereby a model was simulated to determine the number of infections over 28 days based on one case of the monkeypox virus. Findings reveal that the vaccination provides the best intervention, as it effectively reduces the transmission rate and prevents loss of lives in the city. From the model, only three people were infected over the research period, while no deaths were reported. Although vaccination incurs a huge direct cost at the beginning, in the long run, it saves the economy from the disease's financial burden in terms of productivity loss from work absenteeism and premature deaths.

WAYS TO PROTECT BANK ASSETS IN CRISIS IN AZERBAIJAN

The article is about the current structure and features of Azerbaijani banking. The article follows the global financial crisis that began in 2008. Restructuring of Azerbaijan's banking sector has been investigated. The Central Bank prevents the crisis in order to ensure financial stability. The important reforms that have been analyzed and are effective in solving global financial problems and the implementation of a policy aimed at modernization in the banking sector have been recommended. Systemic risk is an important issue for banks in the banking sector. The section refers to the threat of bankruptcy and liquidity problems, in other words, the possibility of a systemic banking crisis. Systemic banking crises have led to significant real economic and financial costs. Although the real consequences of the banking crisis are that economic costs are usually measured in terms of production losses, the cost of transferring government funding to financially troubled banks is related to costs. Keywords: banking system, banking crisis, systemic banking, real economy

Multi-Objective Genetic Algorithm and CNN-Based Deep Learning Architectural Scheme for effective spam detection

E-mail has traditionally been regarded as the most powerful medium in online social networks, where users can discuss, connect, and share links with other online social media users. In particular, Twitter, in particular, has been determined to be the most popular social network that serves as the best communication channel for its users to share current news, ideas, thoughts, comments, and beliefs with other online social media users. Despite the efforts put in to combat spam operations on the online social network, Twitter spam has a new type of functionality that is limited to 140 characters. It is not only the major cause of annoyance for day-to-day users, but also responsible for the majority of computer security issues that cost billions of dollars in terms of productivity losses. In this paper, we propose a Multi-Objective Genetic Algorithm and a CNN-based Deep Learning Architectural Scheme (MOGA–CNN–DLAS) for the predominant Twitter spam detection process. The experimental details and results discussions of the proposed MOGA-CNN-DLAS are evaluated in terms of accuracy, precision, recall, F-Score, RMSE, and MAE by varying the ratio of training data under the utilization of three real datasets, such as the Twitter 100k dataset and the ASU dataset.

Economic Impacts of Clinical and Sub Clinical Mastitis on Dairy Farms

Studies have reported on the economic impacts of clinical and subclinical mastitis on dairy farms. Bovine mastitis is a disorder that affects dairy farms and has a major economic impact. Most of the economic losses are the result of mastitis. Mastitis is an invasive infection that is among the most numerous and highly complicated infections in the dairy sector. Mastitis is one of the most expensive diseases in terms of production losses among animal diseases. Mastitis reduces milk production, changes milk composition, and shortens the productive life of infected cows. Farmers must concentrate on avoiding mastitis infection whilst putting in place and following a mastitis control programed. Bovine mastitis, the most significant disease of dairy herds, has huge effects on farm economics. Mastitis losses are due to reduced milk production, the cost of treatments, and culling. Major factors related to low milk yield could be low genetic potential as well as poor nutritional and managerial approaches. Most of the losses are related to somatic cell count (SCC), which is characterised by an increase in the percentage of milk. Culling costs are the costs of rearing or buying a replacement animal, mostly heifers. Overhead impacts include the replacement animals' lower milk supply effectiveness. The expense of replacing animals prematurely due to mastitis is one of the most significant areas of economic loss.

The Cost of Locally Advanced Cervical Cancer in Thailand: an Empirical Study for Economic Analysis.

Objective:To evaluate cost of illness of locally advanced cervical cancer patients from societal perspective in three scenarios including completely cured without severe late side effects (S1), completely cured with late grade 3-4 gastrointestinal side effects (S2.1) or genitourinary side effects (S2.2), and disease recurrence and death (S3). Methods: The incidence-based approach was conducted. The cost was calculated for 5-year time horizon starting for the treatment initiation. Direct medical costs were extracted from hospital database. Cost of using two-dimensional technique and three-dimensional conformal radiation therapy were calculated separately. Direct non-medical costs and indirect costs in terms of productivity loss were based on actual expenses from the interview of 194 locally advanced cervical cancer patients from two tertiary hospitals in Bangkok, during June to December 2019. All costs were converted to US dollar in 2019 values. Results:For 5 years, cost of illness per patient for using two-dimensional technique and three-dimensional conformal radiation therapy were US $8,391 and US $10,418 for S1, US $18,018 and US $20,045 for S2.1, US $17,908 and US $19,936 for S2.2, and US $61,076 and US $63,103 for S3, respectively. The economic burden for newly diagnosed locally advanced cervical cancer patients in Thailand in 2018 was approximately US $129 million and US $131 million for using two-dimensional technique and three-dimensional conformal radiation therapy, respectively. Cost from S3 accounted for 70% of all total cost. Premature death was the most important cost driver of cost of illness accounted for 64 % of the total cost estimates. Conclusions:Cost of illness of locally advanced cervical cancer patients produced significant economic burden from societal perspective. Disease recurrence and early death from cancer was the most influential cause of this burden.

Cost Savings From a Policy to Diagnose and Prevent Transmission of Adenoviral Conjunctivitis in Employees of a Large Academic Medical Center

Adenoviral conjunctivitis is highly contagious, can be associated with systemic infections, and can cause chronic visual impairment. It accounts for a large proportion of acute conjunctivitis. Outbreaks of epidemic keratoconjunctivitis (EKC) are costly in terms of productivity loss from work furloughs and spread to patients and have resulted in clinic and departmental closures. To examine the institutional cost savings of a policy to diagnose adenoviral conjunctivitis and triage and furlough medical center employees with this condition to prevent outbreaks. This quality improvement study assessed Johns Hopkins Medicine employees with red eye from November 1, 2011, through October 31, 2018, who were triaged at the occupational health clinic whose conditions were diagnosed using polymerase chain reaction (PCR) validated for adenoviral conjunctivitis. Only employees with positive PCR test results were furloughed, with furlough length tailored to subtype (a minimum of 2 weeks for EKC and 1 week otherwise). Total number of furloughs avoided and cost savings associated with reducing unnecessary furloughs. Of 2142 employees with red eye, 1520 (71.0%) underwent PCR testing; 130 (8.6%) had positive adenoviral PCR test results, of whom 41 (31.5%) had EKC. Furloughing 130 employees with positive PCR test results vs furloughing all 1520 employees clinically suspected of having adenoviral conjunctivitis represented an estimated annual savings of $442 073, or $3 094 511 during 7 years. The cost of performing PCR on employees suspected of having adenoviral conjunctivitis was 5.0% of the cost associated with furloughing all employees with red eye. No outbreaks occurred. In this quality improvement study, this policy, notable for development and use of PCR for adenoviral conjunctivitis on a large scale, resulted in substantial cost savings from fewer work furloughs compared with the number of employees who would have been furloughed based on clinical diagnosis. These results may provide impetus for policy adoption by other institutions and for development of a rapid, sensitive, and specific diagnostic test for adenoviral conjunctivitis.

Evaluation of productivity losses due to premature mortality from colorectal cancer

Cancer is responsible annually for around 27% of all deaths in Spain, 15% of which are caused by colorectal cancer. This malignancy has increased its incidence considerably over the past years, which surely impacts global productivity losses. The evaluation of lost productivity due to premature mortality provides valuable information that guides healthcare policies into the establishment of prevention and screening programs. The purpose of this study was to assess the productivity losses from premature deaths due to colorectal cancer over a ten year period (2008–2017). The costs derived from premature mortality due to this highly prevalent cancer were estimated using data on mortality, age- and sex-specific reference salaries and unemployment rates in Spain via the human capital approach. Between 2008 and 2017, 15,103 persons died per year from colorectal cancer, representing almost 15% of all cancer-related deaths. Annually, 25,333 years of potential productive life were estimated to be lost on average, 14,992 in males and 10,341 in females. Productivity losses summed €510.8 million in in 2017, and the cancers of the colon and rectum accounted for 9.6% of cancer-related productivity losses in 2017 in Spain. Colorectal cancer has an important weight in terms of productivity losses within the Spanish population, consequently, prevention and early detection programmes should be promoted and implemented to achieve significant reductions in mortality and productivity losses.

Predicting the mortality of melioidosis in the heart of Borneo

Background: Melioidosis, caused by Burkholderia pseudomallei, is prevalent in rural areas of Malaysia. This soil-dwelling pathogen is inherently resistant to many first-line antibiotics and carries a high mortality rate. Hence, it poses a significant burden of disease in terms of productivity losses among farmers and blue-collar workers in resource-poor environments. There are limited reports on the factors associated with mortality from melioidosis in Borneo. Methods and materials: This study delineates the epidemiological, clinical and microbiological characteristics of melioidosis, and the predictors of mortality. Seventy-three adults, with culture-confirmed melioidosis at Kapit Hospital, Sarawak, Malaysia, over a 3-year period were retrospectively identified. Results: Among 73 patients, diabetes mellitus (28.8%; n = 21) and hypertension (27.4%; n = 20) were reported as the primary risk factors. The clinical spectrum of melioidosis may vary from localised soft tissue (21.9%; n = 16) and joint abscesses (6.9%; n = 5), to a fulminant end of the spectrum, in the form of bacteraemia (64.4%; n = 47), pneumonia (61.6%; n = 45) and internal organ abscesses (49.3%; n = 36). The mortality rate was 12.3% (n = 9). The mean time from presentation to initiation of anti-melioidosis treatment was 2.6 ± 2.3 days. Positive cultures largely came from blood (58.9%, n = 43) and sputum (28.8%; n = 21). All isolates were sensitive to Ceftazidime and 92.7% were sensitive to Gentamicin, which is a unique occurrence in Sarawak. Using univariate analyses, we identified septic shock (p < 0.001), intensive care unit admission (p = 0.001), mechanical ventilation (p < 0.001), serum urea (p < 0.001), serum creatinine (p < 0.001), serum aspartate transaminase (p = 0.037), serum bicarbonate (p < 0.001) and serum albumin (p = 0.025), to be associated with increased risk of mortality. Multivariate logistic regression analyses identified serum bicarbonate (p = 0.004, OR 0.64, 95% CI 0.48–0.87) and serum albumin (p = 0.031, OR 0.73, 95% CI 0.54–0.97), to be the independent predictors of mortality from melioidosis. Conclusion: The identification of these two routine clinical parameters, namely serum bicarbonate and serum albumin, have important prognostic implications in septicaemic melioidosis, which could potentially allow prompt recognition of critically ill patients and timely initiation of anti-melioidosis treatment.

Insights in the pathophysiology of haemorrhagic strokes in a sub-Sahara African country, an epidemiological and MRI study.

Intra-cerebral Haemorrhage (ICH) seems more prevalent in sub-Saharan Africa (SSA) than in High-Income Countries (HIC) with poorer clinical outcome. Higher impact of hypertension and/or amyloid angiopathy could account for this disproportion. Here, we sought to (i) retrospectively compare ICH clinical and imaging patterns in Belgium and Guinea and in a subsequent cohort (ii) prospectively compare brain MRI characteristics to seek evidence for a different proportion of amyloid angiopathy patterns. Ninety one consecutive patients admitted for spontaneous ICH at Brussels Erasme-ULB Hospital and at Conakry Ignace Deen-UGANC were retrospectively compared in terms of ICH volume estimated with the ABC/2 method, clinical characteristics and modified ranking (mRS) score at 30days. mRS was dichotomised as good outcomes (≤3) and poor outcomes (>3). A prospective cohort of 30 consecutive patients with ICH admitted at CHU Conakry Ignace Deen-UGANC was prospectively included to undergo brain MRI. Results of the Guinean MRI were compared to 30 patients randomly selected from Brussels' initial cohort. Paired Student's t-test and Mann-Whitney u-test were used for group comparisons. Age of ICH onset was higher in Belgium (68±17years vs. 56±14years, P<0.01) while ICH volume and 30-day mortality rate were higher in Guinea (20ml vs. 11ml, P<0.01 and mortality 33% vs. 10 %, P<0.01). ICH burden in survivors in Conakry and Brussels showed respectively good outcomes in 56.7% and 60.4% (P=0.09) and poor outcomes in 10.3% vs. 29.6% (P<0.001). MRI analysis of the prospective cohort failed to disclose significant differences regarding brain MRI characteristics. Intra-cerebral Haemorrhage affected patients 15years younger in Guinea with larger haematoma volumes and higher mortality than in Belgium. MRI findings did not show more prevalent amyloid angiopathy pathology suggesting that better primary prevention of hypertension could positively impact ICH epidemiology in Guinea.

Exploratory study

PurposeEmployee engagement recently emerged as a promising mechanism to improve organisational effectiveness and accordingly reduce the performance gap. This paper empirically demonstrates which employee engagement dimension(s) act as the strongest dimension to enhance the levels of employee engagement and consequently organisational effectiveness.Design/methodology/approachThis study used a quantitative approach, specifically a survey design, using a questionnaire to collect data. Regression analysis was applied to predict the impact of the employee engagement dimensions on the level of employee engagement in organisations and the impact of online/social media, as part of communication, on employee engagement.FindingsThe statistical analyses indicate that the dimensions organisational strategy and implementation, organisational commitment and team commitment are significant predictors of employee engagement. On-line/social media has a negative effect on employee engagement. However, according to the results, communication in organisations can be improved, especially by using online/social media more effectively.Research limitations/implicationsThis includes low response rate from some groups.Practical implicationsThe importance of secondary general management tasks, particularly motivation and communication, in mobilising employees to cooperate in pursuing organisational goals, became apparent. This study reflects the adverse effect of a lack of leadership and management skills, and ineffective use of online/social media on organisational performance, as reported in academic and practitioner research. Regardless, practitioners can apply the levers of motivation, via structural dimensions of organisation, to activate psychological presence which drives employee engagement and in turn facilitates strategy implementation and consequently organisational effectiveness. Scholars can modify their research agendas by investigating the “(un)availability” of human resources to improve organisational effectiveness.Social implicationsThe costs of disengaged employees are high, in terms of productivity losses and the performance gap, with adverse consequences for society.Originality/valueEmployee engagement as a driver of strategy implementation is an overlooked area of research. This study offers a better explanation of employee engagement as a mechanism to improve strategy implementation, thus reducing the performance gap, and consequently waste. Employee engagement engenders employee support to pursue organisational goals, in a coordinated system of cooperation, and is produced by the structural dimensions of organisation, the parameters within which psychological presence is activated. Psychological presence drives employee engagement which enables employees to be available to implement strategy to achieve organisational goals and thus organisational effectiveness. Engagement at a broader level than individual is significant.

Work ability and productivity among dentists: associations with musculoskeletal pain, stress, and sleep

PurposeWork ability can be measured by the work ability index (WAI), and work-related questions measuring productivity loss in terms of quality and quantity of work. Dentists have high occupational risk of musculoskeletal pain and the exposure of ergonomic strain is already high during dental education. The aim was to evaluate work ability and productivity among dentists, and to identify gender differences and associations with sleep, stress, and reported frequent pain.MethodsThe study population comprised 187 dentists (123 women and 64 men) who had been working as dentists between 5 and 12 years. Participants completed a questionnaire regarding sleep, stress, presence of pain at different sites, work ability assessed by WAI, and productivity in terms of quality and quantity of work.ResultsPoor sleep quality and high level of stress were reported by 31% and 48.1% of participants, respectively, with no gender differences and no association with age. The prevalence of frequent pain ranged 6.4–46.5% with shoulders being the most prevalent site. Thirty-three percent reported reduced work ability. Poor sleep, high amount of stress, and multi-site pain were associated with decreased work ability.ConclusionsA high prevalence of pain was shown among dentists. Decreased work ability in terms of productivity loss was associated with poor sleep quality, high amount of stress, and multi-site pain. Preventive actions at the workplace should promote good musculoskeletal health, and measures taken, both individual and organizational, to minimize the risk of high, persistent stress and work-related pain.

An Automated Feature Extraction Algorithm for Diagnosis of Gear Faults

Gears are used for the transfer of mechanical power and are an important part of the electromechanical transmission system. Unexpected failure of gear could cause shutdown of the machines and proves to be expensive in terms of production loss and maintenance. Therefore, reliable condition monitoring is required to protect unexpected gear failures. It has been highlighted in the recently published literature that the gear faults appear at the specific gear frequencies in the instantaneous power spectrum of the motor. However, the amplitudes of these gear frequencies are very small and are shadowed by the environment noise. Thus, reliable diagnosis of gear faults is a challenge in real-time fault diagnosis systems. This issue has been addressed in this paper through the development of the automated spectral extraction algorithm. The theoretical investigation has been verified through the custom-designed experimental test rig.

Microalgae growth optimization in open ponds with uncertain weather data

Although microalgae-based processes are currently one of the most promising new technologies for the substitution of fossil fuels and chemicals, the theoretical potential of these technologies is currently limited by their low profitability, hence hindering the development of large scale plants in an economically feasible way. One of the process bottlenecks is the cultivation phase, whose operation is complicated by both the involved biological mechanisms complexity and the highly fluctuating weather conditions affecting the system. Available mathematical models describing microalgae growth and pond temperature dynamics through weather data implementation assume perfect knowledge of weather conditions, hence neglecting the inaccuracy of meteorological predictions that is expected even considering short-term forecasts. In this study a sensitivity study is first carried out to evaluate the weather variables that most impact on productivity. Then, two optimization approaches are proposed to prevent potential critical conditions (such as cell death due to too high temperatures) that may arise by using inaccurate weather forecast. The study demonstrates the reliability of the proposed methodologies and compares them in terms of productivity loss and water demand.

Cost-consequence analysis of sitagliptin versus sulfonylureas as add-on therapy for the treatment of diabetic patients in Italy.

ObjectiveDiabetes mellitus is a chronic disease related to a significant impact in both epidemiologic and economic terms. In Italy, around 3.6 million people are affected by diabetes and this number is expected to increase significantly in the next few years. As recommended by current national and international guidelines, metformin (Met) is prescribed as first-line pharmacological treatment, and many pharmacological alternatives are available for patients uncontrolled with Met monotherapy. Despite the availability of many innovative oral antidiabetic drugs (OADs), such as dipeptidyl peptidase 4 inhibitors (DPP4-i) and its first-in-class sitagliptin (SITA), which entered the Italian market in the last 10 years, their usage is consistently lower than traditional drugs such as sulfonylureas (SUs). In fact, due to higher acquisition costs, the prescription of innovative OADs in Italy is restricted to specialist, resulting in a prominent usage of traditional OAD that can be prescribed also by general practitioners (GPs). A cost consequence analysis (CCA) was performed in order to compare SITA with SU, as second-line therapy in add-on to Met, in terms of costs and related clinical events over 36 months.MethodsA CCA was conducted on a hypothetical cohort of 100,000 type 2 diabetes mellitus (T2DM) patients uncontrolled with Met monotherapy, from both the Italian National Health Service (INHS) and societal perspective. Therefore, both direct (drugs, self-monitoring, hypoglycemia, major cardiovascular events [MACEs], and switch to insulin) and indirect costs (expressed in terms of productivity losses) were evaluated. Clinical and economic data were collected through Italian national tariffs, literature, and experts’ opinions. Three expert clinicians finally validated data inputs. To assess robustness of base case results, a one-way sensitivity analysis (OWSA) and a conservative scenario analysis – excluding MACEs – were carried out.ResultsIn the base case analysis, the higher drug costs related to SITA were offset by other management costs (ie, lower use of devices for glycemia self-monitoring, lower incidence of hypoglycemia and MACE, and delay to insulin switch). As a result, the economic evaluation showed that, compared to SU, SITA was cost saving from both societal (−€61,217,723) and INHS (−€51,846,442) perspectives over 3 years as add-on to Met. The base case results were also confirmed by the scenario analysis and by the OWSA performed on the key parameters. The adoption of SITA, in a cohort of 100,000 diabetes patients, would avoid 26,882 non-severe hypoglycemic events, 6,528 severe hypoglycemic events, and 1,562 MACEs.ConclusionThis analysis suggests that, compared to SU, SITA could be a sustainable and cost-saving alternative for the management of T2DM patients uncontrolled with Met monotherapy from both clinical and economic perspectives.

Lameness — preventative management strategies

Sheep lameness is a widespread health issue affecting most flocks within the UK. The authors consider that flock levels above 2% are significant in terms of production losses and challenges with control. Concern for sheep welfare, losses in production of the flock and the associated costs of a lameness problem are some of the reasons for a farmer contacting their veterinary surgeon for help and advice. This article focuses on the common infectious causes of sheep lameness: scald, footrot and contagious ovine digital dermatitis (CODD). It seeks to provide the most up to date research surrounding the aetiology of these diseases and treatments. Defining the risk factors for lameness on a farm is an important aspect when developing a preventative management strategy for the control of lameness. These risk factors will be discussed. The 5-Point Plan is an industry wide recognised plan for controlling lameness. How to implement this plan on farm including the use of vaccination and good practice quarantine procedures will be described in this article.

Cost of illness of urothelial bladder cancer in Italy.

BackgroundUrothelial bladder cancer (UBC) is the ninth most common cancer worldwide. In Italy, the prevalence of the disease is approximately 10%, making it the fourth most prevalent cancer in the country. The increase in prevalence requires continuous surveillance and care, resulting in a significant burden on Italian National Health Service, making any improvement to the strategy for diagnosing and treating this disease important to the medical and scientific community. The aim of this study was to evaluate the UBC cost of illness in the Italian context, collecting the total costs of the disease.MethodsAn economic analysis was carried out in the context of the National Health Service, using data collected from six centers, in order to evaluate direct costs in terms of outpatient, inpatient, and emergency care; pharmaceuticals and follow-up procedures; and indirect costs in terms of productivity losses. Data were collected through aggregated form reports, focusing on patients with an existing diagnosis of UBC who were treated in the last year. The Italian Association of Medical Oncology (AIOM) guidelines were used to identify diagnostic and therapeutic procedures. Statistical analysis was conducted to explore variations among centers.ResultsThe weighted mean total annual cost per patient was € 3,591, where the cost for superficial disease was € 3,252 and that for metastatic disease was € 606. The analysis confirmed a proportional relation between disease severity and disability grade. The UBC cost of illness, considering prevalence and incidence data coming from the 2016 AIOM/Italian Association of Cancer Registries report, was € 1,187,036,344. Indirect costs accounted to 44%, represented by estimated productivity losses.ConclusionOur analysis represents the first economic study of UBC in the Italian context, as well as the first real-life evidence of the current therapeutic algorithm. This study opens the possibility for further analysis on the indirect cost components that represent a great burden for the society, especially for those in the severest stages of the disease with high disability grades.

Polymeric membrane materials selection for high-pressure CO2 removal from natural gas

A quick qualitative comparison of membrane materials is often necessary in the early phases of membrane separation process design. This comparison and final material selection can be complex when a large number of materials and performance properties are involved. In such cases, a model-based material selection method is a very important tool that is needed by the engineers who are responsible for designing membrane separation systems. Therefore, a new performance criterion was proposed in terms of productivity loss. This criterion was used along with other membrane properties such as plasticization pressure, CO2 permeability, and CO2/CH4 selectivity to carry out a multi-objective optimization of membrane material selection for high-pressure membrane gas separation. Results from the analysis revealed that the productivity loss is very essential in evaluating the property of plasticization-resistant membrane materials. It was also shown that membrane material selection can be efficiently optimized using the multi-objective optimization approach.