Utilization Management Research Articles

Barriers and facilitators to quality HS biologic care and outcomes for the Medicaid population across US states

Introduction: Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease characterized by painful skin lesions and dermal abscesses.1 US-based patients with HS are often covered by Medicaid (21.6–31.0%)2–5 with substantial state-by-state variations in coverage. Barriers to accessing biologics for HS may delay treatment and worsen patient outcomes. Here, we report differences in Medicaid criteria to access biologic care for HS across all 50 US states. Procedure/study: A qualitative review of the Medicaid Utilization Management (UM) policies for biologic use in HS was conducted. Data were collected from the Medicaid UM policies, Medicaid websites, and Managed Medicaid UM policies of each state in February 2024. All 50 states were analyzed; barriers to access and discrepancies across state Medicaid UM policies were identified, and opportunities to address these discrepancies in the form of an HS coalition were recognized. The analysis stratified the Medicaid UM criteria for each state for treatment with a biologic (adalimumab/secukinumab) into no or low, medium, and high barrier levels. For high barrier level states, comparison with UM criteria for psoriasis was made. Results: Overall, the UM policies varied widely, and burdensome barriers to biologic care were identified in some states. In total, 40 states had no or low barrier criteria; states with low barrier criteria required an HS diagnosis and a prescription, or inadequate responses to ≥1 therapy (steroids/antibiotics). Alabama, Kentucky, Minnesota, Missouri, Ohio, Oregon, Pennsylvania, and Washington had medium barrier criteria and generally required an HS diagnosis and failure with ≥2 therapies. Here, criteria may be reduced to align with low barrier states. Iowa and Oklahoma had high barrier criteria. Both required ≥3 abscesses or inflammatory nodules, an HS diagnosis with Hurley Stage II/III, and failure with ≥2 therapies. In Iowa, eligible requests received three months treatment, with additional authorizations conditional upon ≥50% reduction in abscess and nodule count. The approval criteria of biologics for psoriasis were less stringent than HS in Iowa and Oklahoma, including fewer criteria items and therapy failures: Iowa ≥2 vs ≥3; Oklahoma ≥1 vs ≥2. Conclusion: Substantial state-by-state variations in Medicaid criteria were observed, with ten out of 50 states having medium to high barriers to accessing biologics. Large disparities in criteria for access to biologic care between psoriasis and HS were observed in two states. These barriers and discrepancies represent opportunities for an HS coalition at the state level, to improve access to care and patient outcomes.6

Ecosystem Structure and Function in the Sea Area of Zhongjieshan Islands Based on Ecopath Model

Based on the field survey and reference data of the sea area of the Zhongjieshan Islands from 2021 to 2022, the Ecopath model was used to analyze the energy flow structure of the marine ecosystem of the sea area of the Zhongjieshan Islands; the energy structure of the marine ecosystem was divided into 21 functional groups, and its nutrient structure, energy flow, and total system characteristics were analyzed. The results show that the credibility of the model is 0.414, which is at a medium level. The trophic level of each functional group of the ecosystem in the sea area of Zhongjieshan Islands was 1–3.48, the energy flow structure of the system was mainly concentrated in the first five grades, and the trophic level was relatively simple, with the average energy transfer efficiency of the system being 8.11%, the energy flow range being 2.81–13.04%, the energy transfer efficiency of the primary producers of the system being 7.25%, and the energy conversion efficiency of the system debris being 9.12%. The total system throughput was 2125.96 t·km−2; The analysis of the overall characteristics of the ecosystem showed that the system connectance index and the system omnivory index were 0.45 and 0.24, respectively, while the Finn’s cycling index was 8.24, the Finn’s mean path length of the system was 2.72, and the total primary production/total respiration was 1.71. In this study, the marine ecosystem model of the sea area of the Zhongjieshan Islands was studied to understand the trophic structure and ecosystem status of the sea area, which is conducive to the sustainable utilization and scientific management of fishery resources in the sea area.

Abstract 4136952: The Clinical Importance of Arrhythmia Notifications During Use of Wearable Cardioverter Defibrillator

Introduction: Wearable cardioverter defibrillators (WCDs) record continuous ECG data for the purpose of delivering treatment for lethal arrhythmias, but occasionally capture non-treatable arrhythmias that may be of clinical value. The purpose of this study was to evaluate the usefulness to health care providers (HCPs) of evaluating and reporting these other recorded ECGs and the impact on additional arrhythmia detection and clinical management decisions. Research Questions: Do clinicians find arrhythmias identified during routine WCD useful? What arrhythmias are observed? Can the identification of these arrhythmias, validation through ZOLL’s Independent Diagnostic Testing Facility (IDTF) and notification to the provider lead to changes in clinical management? Methods: A multi-center, observational study of 52 US HCPs enrolled 474 patients with commercial LifeVest prescriptions and followed them for up to 3 months. All routinely transmitted LifeVest ECG strips (corresponding to Baseline, Patient Initiated, or other automatic event recordings) during this period were analyzed by ECG technicians at the IDTF within ZOLL. These arrhythmias were reported to the HCP who completed a questionnaire assessing the utility (scored 1 to 5) and clinical impact (medication changes, tests, and procedures ordered) of these events. Results: At the conclusion of the study, 22% of patients (105/474) monitored had 112 reportable, unique arrhythmia events that were sent to 34 providers who completed questionnaires regarding report utility and clinical management decisions. A significant proportion of reports led to medication changes (40%), additional testing (32%) and procedural interventions (23%). The average usefulness of the reports was 3.63/5 with atrial fibrillation representing the most common arrhythmia, but many variations of ventricular ectopy were also captured which tended to be more clinically useful and impactful. Conclusions: WCD patients experience a high burden of actionable arrhythmias. Monitoring and reporting these arrhythmias over the course of normal wear provides additional clinical value to providers. Those arrhythmias that lead to changes to clinical management are the most useful.

Impact of the Inflation Reduction Act on Patient Access and Out-of-Pocket Costs

The Inflation Reduction Act (IRA) represents a recent policy enactment that will influence prescription drug pricing. This paper examines the IRA's elements and their impact on patients' access to medications, specifically around programs funded by the Centers for Medicare and Medicaid. This review analyzed grey literature on patient medication access concerning the IRA, along with the legislation itself. It finds that the IRA contains six key provisions with the potential to impact patients' access to medications and stakeholder business practices: insulin and vaccine cost share, OOP cost limits, premium stabilizations, drug negotiations, and low-income subsidy programs. Although the IRA presents cost-saving provisions, it may exert downstream effects on new drug innovation, increased medication utilization management by payers and pharmacy benefit managers (PBMs), and how healthcare providers, manufacturers, and payers/(PBMs) work together to balance patient well being with fair economic returns for all stakeholders.

Digital twin for decision support system of industrial utility management

Manufacturing and industrial operations rely heavily on energy that is generated mostly from fossil fuels, such as coal, oil, and natural gas, which harm the environment and contribute to climate change. Thus, renewable energy is being integrated into industrial processes to lessen environmental effects and reduce fossil fuel usage. However, the renewable source performance process can be greatly affected by disturbances and constraints, such as ambient air temperature and relative humidity, minimum utility consumption, and the total energy required, making effective control difficult. This study proposes a digital twin built with machine learning regression techniques for load demand forecasting as a decision-support system for industrial utility management. From the results, the ensemble tree (ET) model produced the highest accuracy, based on validation and test dataset root mean squared error values of 23.164 and 27.558, respectively, and R2 values of 0.96 and 0.95, respectively. The digital twin and load demand forecasting approaches effectively created an efficient operating schedule for industrial utility management. The ET model had a total error of 23.86%, substantially lower than the average load demand's total error of 65.29%. Therefore, the ET model with weather conditions in four scenarios could be recommended to optimize energy utilization when creating the operating schedule.

Utilization management and physician burnout.

This study was designed to assess physician experiences with utilization management and burnout and investigate whether they are linked. We conducted an electronic survey with items related to demographics, profession, utilization management, burnout, and potential policy solutions. The survey was sent to 7222 physicians working in outpatient settings who were recruited from a large, opt-in database. Outcome measures were responses to categorical and Likert-style survey items related to demographics, utilization management, burnout, and potential policy solutions. Of 7222 requests sent, 501 physicians completed the survey and were included in the final data set (77% men; mean [SD] age, 57 [9.8] years; mean [SD] years in practice, 24 [8.9]). Of these, 200 were general practitioners and 301 were nonhospital specialists. Physicians indicated that utilization management procedures for prior authorization (81%), step therapy (79%), and nonmedical switching (69%) were major or significant barriers to their clinical and patient care. More than half (52%) reported spending 6 to 21 or more hours per week on paperwork related to health insurance utilization management, 67% had experienced burnout at some point in their careers, and 64% indicated that utilization management had been a contributing factor to feelings of burnout, with an additional 8% citing it as the main factor. Physicians favored streamlining prior authorization practice (77%), requiring step therapy to be based on science (73%), and ensuring that peer-to-peer reviews are done by qualified medical experts (67%). These findings indicate that utilization management has a detrimental impact on physicians and patient care and contributes to physician burnout.

Exploring the Relationship between Teacher Professional Development and Student Learning Outcomes

Teacher professional development is a key factor in improving education quality and student learning outcomes. This study aims to explore the relationship between teacher professional development and student learning outcomes and identify factors that influence the effectiveness of professional development programs. The method used in this research is a literature review that includes analyzing various studies related to teacher professional development and its impact on student learning outcomes. This study collected data from relevant articles, journals and research reports. The results of the review show that teacher professional development contributes significantly to improving student learning outcomes through improving pedagogical competence, technology utilization and classroom management. However, there are obstacles such as a lack of teacher motivation that affects the effectiveness of the program. This study provides important implications for stakeholders, showing the need for collaboration between the government, educational institutions and teachers in creating a sustainable professional development system. With adequate support, it is expected that professional development can effectively improve the quality of education and student learning outcomes, as well as create a learning environment that is more inclusive and responsive to students' needs.

Integrating carbon reduction and ecological resilience strategies in the silk road economic corridor

The Silk Road Economic Belt has become a pivotal region for China's sustainable development, focusing on the balance between carbon emissions and ecological resilience. Understanding the coordination between these factors is crucial for advancing China's westward economic shift and optimizing urban and demographic structures. This study investigates the coupling and coordination dynamics between carbon emissions and ecological resilience across 15 key cities in the Silk Road Economic Belt, using data from 2008 to 2018. By applying a "pressure-state-response" framework, the ecological resilience of the region is quantitatively assessed. Spatial disparities and the dynamic evolution of coupling coordination are analyzed through the Gini coefficient and kernel density estimation. The findings reveal significant regional variations in ecological resilience and a decline in coupling coordination over time. Shifts in the patterns of coordination indicate opportunities for enhancing resource utilization and environmental management. This research provides theoretical insights for policymakers to improve green development strategies, optimize industrial structures, and plan urban green spaces more effectively within the Silk Road Economic Belt.

52 The bag is not always bad: Implementing a two-step method for urine testing on the inpatient paediatric units

Abstract Background Urinary tract infections (UTIs) are a common source of infection in children. Best practice for diagnosis includes interpreting a urinalysis (UA) and urine culture. Urine cultures obtained through bladder catheterization are invasive and time consuming. A two-step approach with noninvasive UA screen, followed by urine culture if positive has previously demonstrated a reduction in unnecessary catheterizations and urine cultures in children 6-24 months with suspected UTIs. Pre-intervention, there was inconsistent use of screening point-of-care urinalysis prior to bladder catheterization for culture. Objectives To decrease the number of bladder catheterizations in children 6-24 months with a negative screen on Point of Care Test (POCT) urinalysis by 25% over 1 year on paediatrics wards at a paediatric tertiary care centre. Outcome measures: 1. Proportion of bladder catheterizations with negative or no UA screen prior 2. Proportion of UA completed as POCT rather than lab sample Process measures: 1. Number of urinary catheterizations performed for UTI screen 2. Number of times pathway is followed Balancing measure: 1. Missed UTIs Design/Methods Baseline data was collected from the paediatric inpatient units at a tertiary paediatric hospital from April 2020 – April 2021. A two-step pathway for collecting urine samples was adopted, including POCT UA screen on a bag sample, followed by bladder catheterization for culture if positive. The pathway was implemented using the Model for Improvement and multiple PDSA cycles. Intervention focused on education, interdisciplinary collaboration, and process standardization. Results Baseline data demonstrated a high rate of urinary catheter cultures despite a negative UA or no UA prior (69%). After pathway implementation, this rate decreased to 23%, with a reduction in initial UA collected by catheter from 14% to 5% (figure 1). The number of POCT UA performed has increased from a median of 64% pre-intervention to 80% post-intervention, resulting in fewer samples processed in the lab (figure 2). Conclusion Variability in practice for specimen choice for collection and investigation contributed to unnecessary catheterizations. Process standardization successfully improved patient-centered care and efficiency. Next steps include broadening pathway inclusion criteria to the 3–6-month age group. Potential competing interests This work was partially supported by the UMC (Utilization Management Committee) Resource Stewardship Grant. The authors declare no additional sources of funding or conflicts of interest.

Sustainable Development in Rural Underserved Communities through Improved Responsible Management of Decentralized Wastewater Infrastructure: A Focus on the Alabama Black Belt.

Despite global efforts on meeting sustainable development goals by 2030, persistent and widespread sanitation deficits in rural, underserved communities in high-income countries─including the United States (US)─challenge achieving this target. The recent US federal infrastructure funding, coupled with research efforts to explore innovative, alternative decentralized wastewater systems, are unprecedented opportunities for addressing basic sanitation gaps in these communities. Yet, understanding how to best manage these systems for sustainable operations and maintenance (O&M) is still a national need. Here, we develop an integrated management approach for achieving such sustainable systems, taking into account the utility structure, operational aspects, and possible barriers impeding effective management of decentralized wastewater infrastructure. We demonstrate this approach through a binomial logistic regression of survey responses from 114 public and private management entities (e.g., water and sewer utilities) operating in 27 states in the US, targeting the rural Alabama Black Belt wastewater issues. Our assessment introduces policy areas that support sustainable decentralized wastewater systems management and operations, including privatizing water-wastewater infrastructure systems, incentivizing/mandating the consolidation of utility management of these systems, federally funding the O&M, and developing and retaining water-wastewater workforce in rural, underserved communities. Our discussions give rise to a holistic empirical understanding of effective management of decentralized wastewater infrastructure for rural, underserved communities in the US, thereby contributing to global conversations on sustainable development.

GIS and Bhuvan Data as Tools for Agricultural Development and Economic Empowerment in Pune District

This paper examines the use of Geographic Information Systems (GIS) and Bhuvan data to enhance agricultural development and drive economic empowerment in Pune District, Maharashtra, India. GIS technology has been instrumental in optimizing water management, land utilization, and crop management. Likewise, Bhuvan data plays a critical role in monitoring crop growth, identifying diseases, and evaluating land use patterns. These advancements contribute to improved crop yields and increased profits for farmers. The paper highlights the significant impact of GIS and Bhuvan data in promoting agricultural progress in Pune district and suggests that these tools could be effectively implemented in other regions to achieve similar benefits.

Elucidating Heterogeneous Li Insertion Using Single-Crystalline and Freestanding Layered Oxide Thin Film.

The kinetics of interfacial ion insertion govern the uniformity of electrochemical reactions, playing a crucial role in lithium-ion battery performance. In two-dimensional lithium-conducting layered-oxide battery particles, variation in insertion rates across insertion channels remains unclear due to poorly defined crystal orientation at the solid-liquid interface and solid-state-lithium-diffusion length. This ambiguity complicates understanding inhomogeneous lithium-insertion channels activation. A systematic study requires crystallographically predefined interfaces and in situ lithium-concentration mapping. Here, we fabricated a freestanding, (104)-oriented-LiNi1/3Mn1/3Co1/3O2 single-crystal thin film using dissolution-induced release and performed in situ scanning-transmission-X-ray-microscopy to spatially resolve lithium-insertion at well-defined-interfaces. We observed heterogeneous lithium-concentration evolution due to channel-by-channel insertion rate variation, despite the potential for homogeneous lithium distribution via a solid-solution-phase at equilibrium in NMC111. Increasing current density exacerbates this heterogeneity, highlighting channel-by-channel variation. Our findings provide critical insights into battery electrode utilization and lifetime management, potentially guiding the design of more efficient and durable lithium-ion batteries.

The Effects of Different Grazing Periods on the Functional Traits of Leymus chinensis (Trin.) Tzvelev in a Typical Inner Mongolia Steppe

Plant functional traits are effective indicators and predictors of environmental change, revealing plants’ ecological countermeasures and adaptability through phenotypic plasticity. We conducted a 6-year grazing experiment on typical temperate grassland to assess the impact of different grazing periods on the plasticity and variability of the functional traits of Leymus chinensis and the relationship between traits and individual plant biomass. Our study included four treatments: CK (enclosure), T1 (grazing in May and July), T2 (grazing in June and August), and T3 (grazing in July and September). The results for 13 functional traits indicated that the T3 treatment showed the smallest reduction in individual plant biomass, plant height, leaf area, stem length, and leaf length, making it the most effective type of grassland management and optimal for the maintenance and restoration of L. chinensis traits. Under T1, T2, and T3, the plasticity of stem weight, total leaf weight, total leaf area, and stem length was higher and crucial for regulating individual plant biomass. The results underscore that the changes and plasticity of dominant species under grazing treatments are key to understanding the relationship between ecosystem function and grassland management. This study provides a theoretical basis and data support for the adaptive utilization and restoration management of typical grassland resources.

The study on the Internet of Things implication in improving the punctuality of air transportation in bad weather

Air travel is a popular choice for people who seek to travel outside in the present. It greatly promotes communication and economic development. However, flight delays can have seriously disappointing effects on various aspects. For passengers, they not only need a long time to wait and additional expenses, but they also experience more psychological stress. And airlines face economic losses, reduced customer satisfaction, and disruptions in flight scheduling, which further affect operational efficiency. Therefore, this paper aims to explore potential methods that are combined with the Internet of Things to improve the punctuality of air transportation in order to ease the hard situation of flight delays caused by bad weather. And based on the previous related papers, the author of this paper thinks a kind of meteorological monitoring and early warning system can be built based on the Internet of Things to improve real-time weather monitoring and flight scheduling, as well as ground service optimization. Hence, people can improve the punctuality of air transportation by optimizing resource utilization and cost management so that the whole industry can bring significant economic benefits to airline companies and improved travel experiences to passengers.

Medicaid managed care restrictions on medications for the treatment of opioid use disorder.

To examine whether Medicaid managed care plan (MCP) utilization management policies for buprenorphine-naloxone and injectable naltrexone are related to key state Medicaid program policy decisions. We abstracted data on state Medicaid regulatory and policy information from publicly available sources and publicly available insurance benefit documentation from all 241 Medicaid MCPs operating in 2021. In this cross-sectional study, we used bivariate and multivariate analyses to examine whether Medicaid MCP prior authorization and quantity limits on receipt of buprenorphine and injectable naltrexone were associated with key state Medicaid choices to leverage federal funds to expand coverage and eligibility (Medicaid expansion, 1115 waivers) and to regulate Medicaid MCPs (uniform preferred drug lists, medical loss ratio remittance). Models were adjusted for MCP characteristics, including profit status, behavioral health contracting arrangement, National Committee for Quality Assurance accreditation, size, market share, and state opioid overdose death rates. Average marginal effects (AME) were reported. Utilization management was common among MCPs, and restrictions were more commonly applied to buprenorphine than injectable naltrexone, despite its higher cost. States that required MCPs to comply with utilization management policies stipulated in a uniform preferred drug list were more likely to require prior authorization for buprenorphine (AME: 0.29, 95% CI: 0.15-0.42) and injectable naltrexone (AME: 0.25, 95% CI: 0.12-0.38). MCPs in states that required plans to pay back earnings above a certain threshold were less likely to require prior authorization for buprenorphine (AME: -0.30, 95% CI: -0.43 to -0.18). Restrictions on medications for opioid use disorder are widespread among MCPs and vary by medication. State Medicaid regulatory and policy characteristics were strongly linked to MCPs' utilization management approaches. State Medicaid policy and contracting approaches may be levers to eliminate utilization management restrictions on medications for opioid use disorder.

A deep reinforcement learning approach towards distributed Function as a Service (FaaS) based edge application orchestration in cloud-edge continuum

Serverless computing has emerged as a new cloud computing model which in contrast to IoT offers unlimited and scalable access to resources. This paradigm improves resource utilization, cost, scalability and resource management specifically in terms of irregular incoming traffic. While cloud computing has been known as a reliable computing and storage solution to host IoT applications, it is not suitable for bandwidth limited, real time and secure applications. Therefore, shifting the resources of the cloud-edge continuum towards the edge can mitigate these limitations. In serverless architecture, applications implemented as Function as a Service (FaaS), include a set of chained event-driven microservices which have to be assigned to available instances. IoT microservices orchestration is still a challenging issue in serverless computing architecture due to IoT dynamic, heterogeneous and large-scale environment with limited resources. The integration of FaaS and distributed Deep Reinforcement Learning (DRL) can transform serverless computing by improving microservice execution effectiveness and optimizing real-time application orchestration. This combination improves scalability and adaptability across the edge-cloud continuum. In this paper, we present a novel Deep Reinforcement Learning (DRL) based microservice orchestration approach for the serverless edge-cloud continuum to minimize resource utilization and delay. This approach, unlike existing methods, is distributed and requires a minimum subset of realistic data in each interval to find optimal compositions in the proposed edge serverless architecture and is thus suitable for IoT environment. Experiments conducted using a number of real-world scenarios demonstrate improvement of the number of successfully composed applications by 18%, respectively, compared to state-of-the art methods including Load Balance, Shortest Path algorithms.

B-013 Improving the Workflow of Blood and Coagulation Tests in clinical laboratory through the Utilization of Laboratory Automation Track Systems

Abstract Background The Laboratory Automation Track System (TLA) is an automated system designed for executing highly repetitive tasks within a laboratory, commonly applied in biochemical and immunological testing systems. It aims to reduce human errors in specimen handling, enhance the overall process quality, and provide better Turnaround Time (TAT) from specimen collection to result reporting. For the first time in our laboratory, we have integrated the blood and coagulation systems with TLA. Consequently, we seek to evaluate the differences in the testing workflow and reporting efficiency of the blood and coagulation systems after being connected to TLA. Methods Abbott GLP systems Track was the TLA system for connecting with blood and coagulation systems. Two Sysmex XN-9100 fully automatic hematology systems and two Sysmex CS-5100 fully automatic coagulation analyzers were developed for blood and coagulation system, respectively. TUNYEN Laboratory Information System was established for Laboratory information system (LIS). Results Through the analysis of quality indicators and integration with intelligent information systems, improvements have been made, including the reduction of blood collection tube usage, efficient manpower utilization management, tracking of specimen progress and achievement of timely reporting rates.(1)Approximately 2,915 blood collection test tubes are saved every month, with a converted cost of 0.15 USD per tube, and a total saving of 437 USD. And reduce the carbon emissions of 32 kgCO2e, comply with the spirit of ESG sustainable development.(2)The TLA no longer requires staff to collect and deliver specimens as in the past,reducing staff and enhancing work efficiency.One of manpower was saved and new inspection items were developed.(3)Tracking of specimen progress:The laboratory has set up a specimen tracking system to monitor the specimen delivery location and provide timely response to the clinical status.The one-hour TAT for blood and coagulation increased from 82.0% and 76.9% before improvement to 91.8% and 93.3% after improvement respectively. Conclusions The implementation of Laboratory Automation Track Systems (TLA) leads to a reduction in medical errors and specimen sample volume, while also enhancing accuracy and precision, thereby improving the safety of laboratory staff. Although the introduction of TLA may require an initial investment, it brings the benefits of automation, offering ease and efficiency to laboratory processes.

A HOLISTIC APPROACH TO THE BANKING SECTOR: PERFORMANCE AND EFFICIENCY ANALYSIS OF TURKISH BANKS USING CoCoSo AND DEA METHODS

The banking sector is a vital component of global economies, playing a critical role in ensuring financial stability by gathering savings, providing credit, and facilitating various financial transactions. Banks not only support economic growth but also act as intermediaries between surplus and deficit units within the economy. Therefore, evaluating their financial performance and efficiency is crucial for understanding the overall health of the financial system. This study analyzes the financial performance and efficiency of the top 10 banks in Turkey, which are ranked by asset size, over a 10-year period from 2013 to 2022. Using the Combined Compromise Solution (CoCoSo) method, the study ranks these banks based on various financial criteria, such as capital adequacy, asset quality, liquidity, and profitability. CoCoSo is a multi-criteria decision-making method that allows for comprehensive performance analysis by considering multiple factors simultaneously. In addition to CoCoSo, Data Envelopment Analysis (DEA) is used to evaluate the efficiency of these banks in utilizing their resources to generate financial outputs. The study’s findings reveal that privatelyowned banks, particularly Akbank T.A.Ş., consistently rank at the top in terms of both financial performance and efficiency. Akbank’s strong performance is attributed to its effective resource utilization and strategic management decisions. State-owned banks, on the other hand, generally show lower financial performance, even though they exhibit high efficiency levels. This discrepancy suggests that public banks may be focusing on non-profit-driven projects that contribute to public welfare, which in turn affects their overall financial performance. Foreign-owned banks, such as Garanti Bankası and Denizbank, also demonstrate strong financial performance but show varying degrees of efficiency, with Denizbank being relatively less efficient in resource utilization. By employing both the CoCoSo and DEA methods, this study offers a unique dual-method approach that provides a comprehensive evaluation of the Turkish banking sector. The combination of these two methods allows for a more nuanced understanding of both financial performance and efficiency, offering valuable insights for policymakers, bank management, and researchers. The study not only highlights the strengths and weaknesses of individual banks but also underscores the importance of efficient resource management for sustaining competitive advantage in a highly dynamic banking environment. The results of this study can serve as a robust framework for future research on bank performance evaluation, especially in emerging markets. Moreover, the study’s methodology can be applied to other sectors or countries to provide cross-sectional and time-series analysis, contributing to the broader literature on financial performance and efficiency.

A Survey on the Utilization and Quality Management of Handy Tests or Point-of-Care In Vitro Diagnostic Tests in Korea

A Survey on the Utilization and Quality Management of Handy Tests or Point-of-Care <i>In Vitro</i> Diagnostic Tests in Korea

Visualization Method for Mesoscale Eddies Characteristics in Ocean Flow Fields Based on Variable Particle Systems

Visualization of ocean flow fields is a major area of interest in marine science. Existing visualization methods based on randomly generated particles tend to exhibit a uniform distribution. While this approach effectively represents ocean flow fields, it inadequately conveys the characteristic structures within the flow in an intuitive manner. Ocean eddies, as crucial components of ocean dynamics (Patrizio &amp; Thompson, 2021), are key features in visualizing ocean flow fields. Mesoscale eddies, which contain 90% of the ocean's kinetic energy, play a vital role in transporting this energy. These eddies significantly influence local marine environments and are instrumental in understanding the kinetic energy of ocean flow fields, providing valuable insights for fields such as oceanography, meteorology, and climate research. The aim of this study is to establish a method based on variable particle systems. Initially, a feature set for mesoscale eddies and a parameter set for variable particles are defined. By mapping the feature set to the parameter set, we express the characteristic structure of mesoscale eddies dynamically. Using ocean flow field data, we demonstrate the method's ability to effectively highlight the characteristic structures of mesoscale eddies within the flow field through qualitative and quantitative evaluation metrics. By analyzing and visualizing ocean flow fields, we can gain a deeper understanding of their spatiotemporal evolution, thereby uncovering the patterns and regularities of their movement. This research approach not only facilitates the effective development, utilization, and sustainable management of marine resources but also aligns with the demands of digital ocean technology for visualizing marine spatial information.