To see the other types of publications on this topic, follow the link: Fixed Waiting Costs.

Journal articles on the topic 'Fixed Waiting Costs'

Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles

Select a source type:

Consult the top 36 journal articles for your research on the topic 'Fixed Waiting Costs.'

Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.

You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.

Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.

1

Platt, Brennan C. "Queue-rationed equilibria with fixed costs of waiting." Economic Theory 40, no. 2 (April 29, 2008): 247–74. http://dx.doi.org/10.1007/s00199-008-0371-7.

Full text
APA, Harvard, Vancouver, ISO, and other styles
2

Helmmie, Elshaan, and Tri Basuki Joewono. "Elasticity of Travel Time and Travel Cost of Private Vehicles and Public Transportation in Bandung, Indonesia." Civil Engineering Dimension 24, no. 2 (October 3, 2022): 101–8. http://dx.doi.org/10.9744/ced.24.2.101-108.

Full text
Abstract:
Understanding mechanism of users in responding determinant variables to use mode of transport is beneficial to anticipate the effect of policy. This study aims to identify the elasticity value of travel time and travel cost of the users of private vehicles and public transportation. Using data from users of private vehicles and public transport in Bandung, Indonesia, the elasticity of travel time and travel cost was calculated based on estimated multinomial logit model (MNL) logit. The elasticity was calculated based on gasoline prices, parking fees, transfer fees, access times, travel times, and waiting times. Based on the results of the elasticity values for travel attribute, it was found that in access time and travel time, Trans Metro Bandung (TMB) Bus had the largest elasticity of -0,564 and -5,001, respectively, so TMB Bus was the most sensitive to changes in access time and travel time. In terms of waiting times and fixed costs/gasoline, conventional taxi has the highest elasticity values of -2,630 and -1,604, respectively, so conventional taxi is the most sensitive to changes in waiting time and fixed costs/gasoline.
APA, Harvard, Vancouver, ISO, and other styles
3

Lachaine, Jean, Kimberly Guinan, Andrew Aw, Versha Banerji, Isabelle Fleury, and Carolyn Owen. "Impact of Fixed-Duration Oral Targeted Therapies on the Economic Burden of Chronic Lymphocytic Leukemia in Canada." Current Oncology 30, no. 5 (April 24, 2023): 4483–98. http://dx.doi.org/10.3390/curroncol30050339.

Full text
Abstract:
Background: Continuous oral targeted therapies (OTT) represent a major economic burden on the Canadian healthcare system, due to their high cost and administration until disease progression/toxicity. The recent introduction of venetoclax-based fixed-duration combination therapies has the potential to reduce such costs. This study aims to estimate the prevalence and the cost of CLL in Canada with the introduction of fixed OTT. Methods: A state transition Markov model was developed and included five health states: watchful waiting, first-line treatment, relapsed/refractory treatment, and death. The number of CLL patients and total cost associated with CLL management in Canada for both continuous- and fixed-treatment-duration OTT were projected from 2020 to 2025. Costs included drug acquisition, follow-up/monitoring, adverse event, and palliative care. Results: The CLL prevalence in Canada is projected to increase from 15,512 to 19,517 between 2020 and 2025. Annual costs were projected at C$880.7 and C$703.1 million in 2025, for continuous and fixed OTT scenarios, respectively. Correspondingly, fixed OTT would provide a total cost reduction of C$213.8 million (5.94%) from 2020 to 2025, compared to continuous OTT. Conclusions: Fixed OTT is expected to result in major reductions in cost burden over the 5-year projection, compared to continuous OTT.
APA, Harvard, Vancouver, ISO, and other styles
4

Yantao, Huang, Kara M. Kockelman, and Long T. Truong. "SAV Operations on a Bus Line Corridor: Travel Demand, Service Frequency, and Vehicle Size." Journal of Advanced Transportation 2021 (July 12, 2021): 1–15. http://dx.doi.org/10.1155/2021/5577500.

Full text
Abstract:
Before shared automated vehicles (SAVs) can be widely adopted, they are anticipated to be implemented commercially in confined regions or fixed routes where the benefits of automation can be realized. SAVs have the potential to operate in a traditional transit corridor, replacing conventional transit vehicles, and have frequent interactions with riders and other vehicles sharing the same right of way. This paper microsimulates SAVs’ operation on a 6.5-mile corridor to understand how vehicle size and attributes of such SAV-based transit affect traffic, transit riders, and system costs. The SUMO (Simulation of Urban MObility) platform is employed to model microscopic interactions among SAVs, transit passengers, and other traffic. Results show that the use of smaller, but more frequent, SAVs leads to reduced passenger waiting times but increased vehicle travel times. More frequent services of smaller SAVs do not, in general, significantly affect general traffic due to shorter dwell times. Overall, using smaller SAVs instead of the large 40-seat SAVs can reduce system costs by up to 4% while also reducing passenger waiting times, under various demand levels and passenger loading factors. However, the use of 5-seat SAVs does not always have the lowest system costs.
APA, Harvard, Vancouver, ISO, and other styles
5

Mansyur, Abil, Satya Subrahmanyam, Vadim Ponkratov, Candra Zonyfar, Ravil Akhmadeev, and Kavitha Manoharan. "A New Mathematical Model for the Integration of Production and Distribution in Mobile Centers." Mathematical Modelling of Engineering Problems 9, no. 6 (December 31, 2022): 1466–70. http://dx.doi.org/10.18280/mmep.090604.

Full text
Abstract:
In today's competitive environment, having the best sequence of operations for production and distribution activities is a basic need for survival. As a result, one of the major challenges in fixed supply chain systems is unnecessary transportation costs and the inability to meet customer demand as quickly as possible. In order to meet these challenges, factories and mobile equipment have been considered in this study, and have recently been used in several industries, including pharmaceutical, chemical, and dairy. In the course of this study, a novel mathematical model was put forward for an integrated production and distribution scheduling problem taking into account some real-world features, focusing on reducing customer waiting time and also reducing production costs. A small-scale problem was resolved to check the model’s accuracy. The accuracy of the model is affirmed given the example and its solution acquired from GAMS software. The results of the study prove the effectiveness of this model in reducing customer waiting time and production costs and also demonstrate that the model has the capacity to be utilized by all organizations that produce and distribute perishable products, including dairy and pharmaceutical products, chemical compounds and masks during the Coronavirus pandemic.
APA, Harvard, Vancouver, ISO, and other styles
6

Bhulai, Sandjai, and Ger Koole. "On the structure of value functions for threshold policies in queueing models." Journal of Applied Probability 40, no. 3 (September 2003): 613–22. http://dx.doi.org/10.1239/jap/1059060891.

Full text
Abstract:
We study the multiserver queue with Poisson arrivals and identical independent servers with exponentially distributed service times. Customers arriving at the system are admitted or rejected according to a fixed threshold policy. Moreover, the system is subject to holding, waiting, and rejection costs. We give a closed-form expression for the average costs and the value function for this multiserver queue. The result will then be used in a single step of policy iteration in the model where a controller has to route to several finite-buffer queues with multiple servers. We numerically show that the improved policy has a close to optimal value.
APA, Harvard, Vancouver, ISO, and other styles
7

Bhulai, Sandjai, and Ger Koole. "On the structure of value functions for threshold policies in queueing models." Journal of Applied Probability 40, no. 03 (September 2003): 613–22. http://dx.doi.org/10.1017/s0021900200019598.

Full text
Abstract:
We study the multiserver queue with Poisson arrivals and identical independent servers with exponentially distributed service times. Customers arriving at the system are admitted or rejected according to a fixed threshold policy. Moreover, the system is subject to holding, waiting, and rejection costs. We give a closed-form expression for the average costs and the value function for this multiserver queue. The result will then be used in a single step of policy iteration in the model where a controller has to route to several finite-buffer queues with multiple servers. We numerically show that the improved policy has a close to optimal value.
APA, Harvard, Vancouver, ISO, and other styles
8

Kurshev, Alexander, and Ilya A. Strebulaev. "Firm Size and Capital Structure." Quarterly Journal of Finance 05, no. 03 (September 2015): 1550008. http://dx.doi.org/10.1142/s2010139215500081.

Full text
Abstract:
Firm size has been empirically found to be strongly positively related to capital structure. This paper investigates whether a dynamic capital structure model can explain the cross-sectional size–leverage relationship. The driving force that we consider is the presence of fixed costs of external financing that lead to infrequent restructuring and create a wedge between small and large firms. We find four firm-size effects on leverage. Small firms choose higher leverage at the moment of refinancing to compensate for less frequent rebalancings. Their longer waiting times between refinancings lead to lower levels of leverage at the end of restructuring periods. Within one refinancing cycle, the intertemporal relationship between leverage and firm size is negative. Finally, there is a mass of firms opting for no leverage. The analysis of dynamic economy demonstrates that in cross-section, the relationship between leverage and size is positive and thus fixed costs of financing contribute to the explanation of the stylized size–leverage relationship. However, the relationship changes sign when we control for the presence of unlevered firms.
APA, Harvard, Vancouver, ISO, and other styles
9

Jiang, Cheng. "Research on Optimizing Multimodal Transport Path under the Schedule Limitation Based on Genetic Algorithm." Journal of Physics: Conference Series 2258, no. 1 (April 1, 2022): 012014. http://dx.doi.org/10.1088/1742-6596/2258/1/012014.

Full text
Abstract:
Abstract Multimodal transportation is getting more and more attention due to its economical and efficient characteristics. Choosing a reasonable transportation plan can effectively control transportation costs. Considering that there are fixed schedules for railway and waterway transportation in real life, this article will establish a multimodal transportation route optimization model with the goal of minimizing the total transportation cost consisting of transportation cost, transit cost, waiting cost and carbon emission cost. The genetic algorithm based on preservation strategy and immigration strategy is used to solve the model. The effectiveness of the model is proved by the case study, and it can provide decision support for the choice of multimodal transportation scheme.
APA, Harvard, Vancouver, ISO, and other styles
10

Chen, Yiwei, and Ming Hu. "Pricing and Matching with Forward-Looking Buyers and Sellers." Manufacturing & Service Operations Management 22, no. 4 (July 2020): 717–34. http://dx.doi.org/10.1287/msom.2018.0769.

Full text
Abstract:
Problem definition: We study a dynamic market over a finite horizon for a single product or service in which buyers with private valuations and sellers with private supply costs arrive following Poisson processes. A single market-making intermediary decides dynamically on the ask and bid prices that will be posted to buyers and sellers, respectively, and on the matching decisions after buyers and sellers agree to buy and sell. Buyers and sellers can wait strategically for better prices after they arrive. Academic/practical relevance: This problem is motivated by the emerging sharing economy and directly speaks to the core of operations management that is about matching supply with demand. Methodology: The dynamic, stochastic, and game-theoretic nature makes the problem intractable. We employ the mechanism-design methodology to establish a tractable upper bound on the optimal profit, which motivates a simple heuristic policy. Results: Our heuristic policy is: fixed ask and bid prices plus price adjustments as compensation for waiting costs, in conjunction with the greedy matching policy on a first-come-first-served basis. These fixed base prices balance demand and supply in expectation and can be computed efficiently. The waiting-compensated price processes are time-dependent and tend to have opposite trends at the beginning and end of the horizon. Under this heuristic policy, forward-looking buyers and sellers behave myopically. This policy is shown to be asymptotically optimal. Managerial implications: Our results suggest that the intermediary might not lose much optimality by maintaining stable prices unless the underlying market conditions have significantly changed, not to mention that frequent surge pricing may antagonize riders and induce riders and drivers to behave strategically in ways that are hard to account for with traditional pricing models.
APA, Harvard, Vancouver, ISO, and other styles
11

Phan, Ha Thi Mai. "A simulated annealing algorithm for vehicle scheduling problem." Science & Technology Development Journal - Economics - Law and Management 1, Q4 (October 31, 2017): 70–77. http://dx.doi.org/10.32508/stdjelm.v1iq4.477.

Full text
Abstract:
As the construction activity has been growing, the companies that supply fresh concrete expand their production scale to meet their customers’ needs. The more customers, the longer queue tank trucks have to wait to pick up the fresh concrete. The customers are construction companies that have different construction works at the same time while the transportation time is only at night. They have to schedule efficiently the fleet of fresh concrete tank trucks during the night (turning the tank trucks a few turns) with constraints on the time window for the transfer of fresh concrete from the concrete company to the construction site as well as constraints on the waiting time for loading fresh concrete in the company. The scheduling for the fleet of construction company’s tank trucks will be modeled to minimize total transportation costs (fixed, variable) with estimated waiting times and tank truck’s turns several times during the night. The model of logistics problem is NP hard; Therefore, two algorithms are proposed to find the nearly optimal solution: heuristics and simulated annealing algorithm. The results will be compared and analyzed.
APA, Harvard, Vancouver, ISO, and other styles
12

Aboolian, Robert, Oded Berman, and Majid Karimi. "Probabilistic Set Covering Location Problem in Congested Networks." Transportation Science 56, no. 2 (March 2022): 528–42. http://dx.doi.org/10.1287/trsc.2021.1096.

Full text
Abstract:
This paper focuses on designing a facility network, taking into account that the system may be congested. The objective is to minimize the overall fixed and service capacity costs, subject to the constraints that for any demand the disutility from travel and waiting times (measured as the weighted sum of the travel time from a demand to the facility serving that demand and the average waiting time at the facility) cannot exceed a predefined maximum allowed level (measured in units of time). We develop an analytical framework for the problem that determines the optimal set of facilities and assigns each facility a service rate (service capacity). In our setting, the consumers would like to maximize their utility (minimize their disutility) when choosing which facility to patronize. Therefore, the eventual choice of facilities is a user-equilibrium problem, where at equilibrium, consumers do not have any incentive to change their choices. The problem is formulated as a nonlinear mixed-integer program. We show how to linearize the nonlinear constraints and solve instead a mixed-integer linear problem, which can be solved efficiently.
APA, Harvard, Vancouver, ISO, and other styles
13

Xu, Wangtu, Lixin Miao, and Wei-Hua Lin. "Stochastic User Equilibrium Assignment in Schedule-Based Transit Networks with Capacity Constraints." Discrete Dynamics in Nature and Society 2012 (2012): 1–15. http://dx.doi.org/10.1155/2012/910754.

Full text
Abstract:
This paper proposes a stochastic user equilibrium (SUE) assignment model for a schedule-based transit network with capacity constraint. We consider a situation in which passengers do not have the full knowledge about the condition of the network and select paths that minimize a generalized cost function encompassing five components: (1) ride time, which is composed of in-vehicle and waiting times, (2) overload delay, (3) fare, (4) transfer constraints, and (5) departure time difference. We split passenger demands among connections which are the space-time paths between OD pairs of the network. All transit vehicles have a fixed capacity and operate according to some preset timetables. When the capacity constraint of the transit line segment is reached, we show that the Lagrange multipliers of the mathematical programming problem are equivalent to the equilibrium passenger overload delay in the congested transit network. The proposed model can simultaneously predict how passengers choose their transit vehicles to minimize their travel costs and estimate the associated costs in a schedule-based congested transit network. A numerical example is used to illustrate the performance of the proposed model.
APA, Harvard, Vancouver, ISO, and other styles
14

Kovač, Nataša, Tatjana Davidović, and Zorica Stanimirović. "Population-based Metaheuristics for the Dynamic Minimum Cost Hybrid Berth Allocation Problem." International Journal on Artificial Intelligence Tools 30, no. 04 (June 2021): 2150017. http://dx.doi.org/10.1142/s0218213021500172.

Full text
Abstract:
This study considers the Dynamic Minimum Cost Hybrid Berth Allocation Problem (DMCHBAP) with fixed handling times of vessels. The objective function to be minimized consists of three components: costs of positioning, waiting, and tardiness of completion for all vessels. A mathematical formulation of DMCHBAP, based on Mixed Integer Linear Programming (MILP), is proposed and used within the framework of commercial CPLEX 12.3 solver. As the speed of finding high-quality solutions is of crucial importance for an efficient and reliable decision support system in container terminal, two population-based metaheuristic approaches to DMCHBAP are proposed: combined Genetic Algorithm (cGA) and improvement-based Bee Colony Optimization (BCOi). Both cGA and BCOi are evaluated and compared against each other and against state-of-the-art solution methods for DMCHBAP on five sets of problem instances. The conducted computational experiments and statistical analysis indicate that population-based metaheuristic methods represent promising approaches for DMCHBAP and similar problems in maritime transportation.
APA, Harvard, Vancouver, ISO, and other styles
15

Lachaine, Jean, Catherine Beauchemin, Kimberly Guinan, Philippe Thebault, Andrew Aw, Versha Banerji, Isabelle Fleury, and Carolyn Owen. "Impact of Oral Targeted Therapy on the Economic Burden of Chronic Lymphocytic Leukemia in Canada." Current Oncology 28, no. 1 (January 9, 2021): 332–45. http://dx.doi.org/10.3390/curroncol28010037.

Full text
Abstract:
Background: Continuous oral targeted therapy (OTT) for chronic lymphocytic leukemia (CLL) represents an effective therapy but also a major economic burden on the healthcare system. This study aimed to estimate future direct costs, along with the prevalence, of CLL in the era of continuous OTT in Canada. Methods: The economic burden of OTT was modelled and compared to chemoimmunotherapy (CIT), for CLL treatment. The burden was assessed/projected from 2011 to 2025. For the OTT scenario, CIT was considered the standard of care before 2015, while OTT was considered standard of care for patients with either unmutated immunoglobulin heavy-chain variable (IGHV) or del(17p)/TP53 mutations starting in 2015 and, from 2020 onwards, for all first-line treatments except for patients with mutated IGHV. A Markov model was developed including four health states: watchful-waiting, first-line treatment, relapse and death. Costs of therapy, follow-up/monitoring and adverse events were included. Key clinical parameters were extracted from pivotal clinical trials. Results: As incidence rates and rate of survival are increasing, the prevalence of CLL in Canada is projected to increase 1.8-fold, from 8301 patients in 2011 to 14,654 by 2025. Correspondingly, the total annual costs of CLL management are predicted to increase 15.7-fold, from $60.8 million to $957.5 million during that same period. Conclusions: Although OTT enhances survival for patients with CLL, it is nonetheless associated with an important economic burden due to the projected vast increase in costs from 2011 to 2025. Changes in clinical strategies, such as implementation of a fixed OTT treatment duration, could help alleviate financial burden.
APA, Harvard, Vancouver, ISO, and other styles
16

Mandegar, Mohammad A., and Sarah P. Otto. "Mitotic recombination counteracts the benefits of genetic segregation." Proceedings of the Royal Society B: Biological Sciences 274, no. 1615 (March 13, 2007): 1301–7. http://dx.doi.org/10.1098/rspb.2007.0056.

Full text
Abstract:
The ubiquity of sexual reproduction despite its cost has lead to an extensive body of research on the evolution and maintenance of sexual reproduction. Previous work has suggested that sexual reproduction can substantially speed up the rate of adaptation in diploid populations, because sexual populations are able to produce the fittest homozygous genotype by segregation and mating of heterozygous individuals. In contrast, asexual populations must wait for two rare mutational events, one producing a heterozygous carrier and the second converting a heterozygous to a homozygous carrier, before a beneficial mutation can become fixed. By avoiding this additional waiting time, it was shown that the benefits of segregation could overcome a twofold cost of sex. This previous result ignores mitotic recombination (MR), however. Here, we show that MR significantly hastens the spread of beneficial mutations in asexual populations. Indeed, given empirical data on MR, we find that adaptation in asexual populations proceeds as fast as that in sexual populations, especially when beneficial alleles are partially recessive. We conclude that asexual populations can gain most of the benefit of segregation through MR while avoiding the costs associated with sexual reproduction.
APA, Harvard, Vancouver, ISO, and other styles
17

Juniana, Paula, and Lukman Hakim. "TRAFFIC LIGHT CONTROL USING FUZZY LOGIC MAMDANI METHOD." Jurnal Terapan Teknologi Informasi 3, no. 1 (June 27, 2019): 1–10. http://dx.doi.org/10.21460/jutei.2019.31.126.

Full text
Abstract:
Traffic congestion is a common occurrence in Indonesia. Traffic congestion is increasing from year to year, causing many things to happen, such as longer travel time, increased transportation costs, serious disruptions to transporting products, decreasing levels of work productivity, and wasteful use of labor energy. Congestion is also caused by a traffic light control system that is made with a fixed time so it can not detect the density of certain paths. Traffic lights in Indonesia, frequent damage that makes the density and the flow of his road vehicles can not be controlled. From these problems, conducted research to reduce the density of vehicles using infrared sensors and see the waiting time of the vehicle when the red light. The traffic light control system will use Fuzzy Logic Mamdani method. In Mamdani method by applying fuzzy into each variable and will be done matching between rule with condition which fulfilled to determine contents of output to be executed by prototype. This congestion detection will help the system in controlling the green light time by looking at stable, medium, and traffic jams. When the bottleneck starts to detect, the prototype will add a green light time according to the condition that is 0 seconds, 5 seconds, 10 seconds, and 15 seconds. However, when the streets are not detected by traffic jams, the green light will be back to normal at 15 seconds without additional time
APA, Harvard, Vancouver, ISO, and other styles
18

Juniana, Paula, and Lukman Hakim. "TRAFFIC LIGHT CONTROL USING FUZZY LOGIC MAMDANI METHOD." Jurnal Terapan Teknologi Informasi 3, no. 1 (June 27, 2019): 1–10. http://dx.doi.org/10.21460/jutei.v3i1.126.

Full text
Abstract:
Traffic congestion is a common occurrence in Indonesia. Traffic congestion is increasing from year to year, causing many things to happen, such as longer travel time, increased transportation costs, serious disruptions to transporting products, decreasing levels of work productivity, and wasteful use of labor energy. Congestion is also caused by a traffic light control system that is made with a fixed time so it can not detect the density of certain paths. Traffic lights in Indonesia, frequent damage that makes the density and the flow of his road vehicles can not be controlled. From these problems, conducted research to reduce the density of vehicles using infrared sensors and see the waiting time of the vehicle when the red light. The traffic light control system will use Fuzzy Logic Mamdani method. In Mamdani method by applying fuzzy into each variable and will be done matching between rule with condition which fulfilled to determine contents of output to be executed by prototype. This congestion detection will help the system in controlling the green light time by looking at stable, medium, and traffic jams. When the bottleneck starts to detect, the prototype will add a green light time according to the condition that is 0 seconds, 5 seconds, 10 seconds, and 15 seconds. However, when the streets are not detected by traffic jams, the green light will be back to normal at 15 seconds without additional time
APA, Harvard, Vancouver, ISO, and other styles
19

Jones, Siobhan, Paul M. Button, and Julie A. Button. "A 5-year journey of improvement in a nurse-led botulinum toxin type A clinic for chronic migraine." British Journal of Neuroscience Nursing 18, no. 1 (February 2, 2022): 22–25. http://dx.doi.org/10.12968/bjnn.2022.18.1.22.

Full text
Abstract:
To enable the clinic to meet the increasing demand for botulinum toxin type A (BoNTA) treatment the clinic developed a continuous process improvement programme in 2015. The configuration of clinic setup was standardised by utilising lean techniques and patients were categorised as ‘runners’ (uncomplicated/routine), ‘repeaters’ (more time-consuming, complex) and ‘strangers’ (new patients). This enabled a standardised patient pathway with fixed appointment times. The time allocated depended on the type of patient and whether the patient could be treated in a 15-minute or a 30-minute time slot. Objectives: To measure and monitor the value created by the continuous improvement process, to refine service delivery including the efficiency and capacity of the chronic migraine clinic. Method: Data was collected at the end of each month and a trend analysis of the number of chronic migraine patient treatments was carried out. Corrective actions were taken if the number of treatments fell below the anticipated demand. We calculated the increased capacity over the five-year period based on the data collected. To determine if the increased capacity required additional human resources, we also reviewed the headache specialist nurse resources allocated for chronic migraine treatments over the same period. Results: In 2015 the clinic had a waiting list of 35 patients, with a wait time of 4-6 months. At that time there was only capacity to accommodate 28 new patient referrals for BoNTA. During the period between 2015 and 2019, the total number of yearly treatments more than doubled from 791 to 1634. The clinic, at this point, was conducted by one headache specialist nurse. An additional nurse was then employed to support the increasing demand in early 2019. After implementing the improved process the clinic was able to eliminate the waiting list. In 2019 it generated capacity to accommodate 116 new patient referrals, which was an increase of 414% compared to 2015. Conclusions: The service efficiency programme implemented in 2015 has enabled the clinic to increase capacity to meet the increasing demands in the administration of BoNTA treatment. For the first 4 years, this was achieved without incurring any additional nursing costs. In addition, because of the success of the programme, more patients with chronic migraine have benefited from accessing BoNTA treatment.
APA, Harvard, Vancouver, ISO, and other styles
20

Hirsch-Moverman, Yael, Michael Strauss, Gavin George, Anthony Mutiti, Arnold Mafukidze, Siphesihle Shongwe, Gloria Sisi Dube, Wafaa M. El Sadr, Joanne E. Mantell, and Andrea A. Howard. "Paediatric tuberculosis preventive treatment preferences among HIV-positive children, caregivers and healthcare providers in Eswatini: a discrete choice experiment." BMJ Open 11, no. 10 (October 2021): e048443. http://dx.doi.org/10.1136/bmjopen-2020-048443.

Full text
Abstract:
ObjectiveIsoniazid preventive therapy initiation and completion rates are suboptimal among children. Shorter tuberculosis (TB) preventive treatment (TPT) regimens have demonstrated safety and efficacy in children and may improve adherence but are not widely used in high TB burden countries. Understanding preferences regarding TPT regimens’ characteristics and service delivery models is key to designing services to improve TPT initiation and completion rates. We examined paediatric TPT preferences in Eswatini, a high TB burden country.DesignWe conducted a sequential mixed-methods study utilising qualitative methods to inform the design of a discrete choice experiment (DCE) among HIV-positive children, caregivers and healthcare providers (HCP). Drug regimen and service delivery characteristics included pill size and formulation, dosing frequency, medication taste, treatment duration and visit frequency, visit cost, clinic wait time, and clinic operating hours. An unlabelled, binary choice design was used; data were analysed using fixed and mixed effects logistic regression models, with stratified models for children, caregivers and HCP.SettingThe study was conducted in 20 healthcare facilities providing TB/HIV care in Manzini, Eswatini, from November 2018 to December 2019.ParticipantsNinety-one stakeholders completed in-depth interviews to inform the DCE design; 150 children 10–14 years, 150 caregivers and 150 HCP completed the DCE.ResultsDespite some heterogeneity, the results were fairly consistent among participants, with palatability of medications viewed as the most important TPT attribute; fewer and smaller pills were also preferred. Additionally, shorter waiting times and cost of visit were found to be significant drivers of choices.ConclusionPalatable medication, smaller/fewer pills, low visit costs and shorter clinic wait times are important factors when designing TPT services for children and should be considered as new paediatric TPT regimens in Eswatini are rolled out. More research is needed to determine the extent to which preferences drive TPT initiation, adherence and completion rates.
APA, Harvard, Vancouver, ISO, and other styles
21

Bidois, Marisa. "The cost of convenience." Hospitality Insights 3, no. 1 (June 21, 2019): 1–2. http://dx.doi.org/10.24135/hi.v3i1.10.

Full text
Abstract:
Hospitality businesses in New Zealand are seeing fewer and fewer payments made by cash, as customers opt for the convenience of paying their bill electronically. If customers love the convenience of paying by credit card, who should be responsible for the cost of this convenience – the business or the customer? In a Restaurant Association survey conducted at the end of last year, members overwhelmingly (71%) indicated that the use of cash by customers is declining, with a Mastercard New Zealand survey last year backing this up. This widespread adoption of electronic payment by consumers sees merchants bearing the significant cost of the transaction through their merchant fees. New Zealand merchants pay substantially more to process credit and contactless debit card transactions than their counterparts in Australia and the UK (on average, New Zealand merchants pay merchant service fees of around 1.4%, while in Australia it is around 0.85%, according to estimates by COVEC and data from the Reserve Bank of Australia). Restaurant Association members typically pay even higher – between 1.8% and 2% in fees for each credit card transaction; members say they are charged the same rate for any card type. Forty-two percent have a ‘fixed bundled rate’, although another 26% say they are charged a split rate for credit card and debit cards. Only 5% have an ‘unbundled’ merchant fee, where different types of cards are charged different fees and merchants pay this cost plus an acquiring service fee from the bank. There are undoubtedly advantages for businesses in accepting electronic payments, primarily in the speed of the transaction – particularly with several customers waiting to pay – and the speed in which the payment is deposited into your bank account. However, it comes at a large cost, which is challenging for an industry that runs on very small margins already. One member pointed out in the Association’s recent survey: As the average return in New Zealand is 6% net profit, the banks are effectively charging 1/3 of the profit of the average business, which is diabolical. With technology advancements their costs have gone down but charges have gone up, clearly shown in their bottom line profits. It is a collective monopoly like a lot of big business in New Zealand. (Restaurant Association member) Of our members, 66% say they would switch if they could receive a saving equating to an overall 2.5–5% reduction in the cost of accepting credit cards. Currently though, short of refusing to accept credit card payments, it is difficult to avoid merchant fees. Emerging payment options and growing trends via NFC (Near Field Communication) capable mobile phones (such as ApplePay, GooglePay and Digital Wallets) are now more widely available. Whilst offering convenience and arguably faster transaction speed, these payment methods offer no relief to the fee incurred by a business for acceptance. Alternative payment solutions now exist in New Zealand, but there are few choices. To date, most are aimed at the Chinese market, with payment methods restricted to tourist and student visitors, and immigrants retaining banking capability in their country of origin. The Restaurant Association’s survey indicated that only 24% of members currently accept other payment channels like China Union Pay, Alipay or WeChat. In reality these alternative payment solutions currently only form a small portion of the total volume of transactions a business processes, so will not affect any meaningful reduction in the total costs of cards/payment processing. Surcharging, however, is a way for operators to offset the merchant fee imposed upon them by the banks. Surcharging simply means a charge to cover a merchant’s cost for processing a credit card. They are now being used by increasing numbers of tourism and hospitality businesses. Feedback from member businesses is that there is little reaction or negative feedback from customers. A Restaurant Association member commented on the survey: We added a surcharge to cover the transaction fee on credit cards and have had no complaints. It’s just a matter of cents and gives us an opportunity to explain that we have always worn the cost of the surcharges but this is increasingly difficult. Feedback from some members is that they find the practice unfriendly and others would prefer to incorporate this fee into their menu pricing structure, as this member pointed out: “I don’t care about the cost. It is added into the budgets and is picked up at menu price changes time, so it is paid for by the customer anyway.” Individual businesses need to decide if a surcharge would create tension in the business/customer relationship however, it is reassuring to know that, if a business does decide to add a surcharge, it is becoming a far more mainstream option than it used to be. From a legal standpoint, merchants are required under the Fair Trading Act to ensure representations around their card payment fees are accurate and not misleading. This means if you are being charged a 1.8% merchant fee by your bank, it is not reasonable to apply a 3% credit card convenience fee to your customer. We’ve noticed some merchants prefer to pass on only a portion of the cost with a surcharge – say 1% – as a cost recovery practice. For a $100 bill, that is just a $1 addition to the bill for the consumer. The payments landscape is changing rapidly, and in the future new technology will dramatically change the way we pay and receive payments. In the meantime, the Restaurant Association are developing further information for members around surcharging, with implementation and training for staff. We’ll also continue advocating on behalf of members to ensure the payment system delivers good outcomes for both consumers and our member merchants. Corresponding author Marisa Bidois can be contacted at: marisa@restaurantnz.co.nz
APA, Harvard, Vancouver, ISO, and other styles
22

Das Gupta, Supratim, and Alejandro Mosiño. "Evaluating India’s energy targets using real options approach." International Journal of Energy Sector Management 14, no. 4 (January 15, 2020): 757–76. http://dx.doi.org/10.1108/ijesm-04-2019-0020.

Full text
Abstract:
Purpose The authors formulate India’s energy targets in light of pushing for renewable energy sources and reducing the dependence on imported coal. Share of imported coal in electricity generation has been approximately 10 per cent in recent years. While investments in renewables have grown in recent years as seen in installed capacities, coal-fired electricity generation has grown because of rising demand for electricity. The purpose of this study is to find a planner solution when high global coal prices force greater investments in renewable energies. Design/methodology/approach The authors use real options approach where global coal prices are the stochastic variable. They present an optimal stopping problem and solving the problem backward, the revenues from continuing with the current energy generation mix and those from replacing imported coal with wind and solar is compared for each period. Findings The “trigger price” for global coal prices when it is optimal for the social planner to invest in additional wind and solar capacities is found. Trigger prices is the threshold when investment must be undertaken whatever be the future evolution of coal prices; this gives the problem a value of waiting. India cannot afford to wait to invest if faced with strict short-term goals. Originality/value The work evaluates India’s domestic targets and its Paris Agreement goals in light of using more of wind and sun and replacing imported coal. Various data sources (government reports, research articles) are consulted to predict shares of electricity from various sources in future and the authors find the operating costs and the investment costs associated with switching to renewables.
APA, Harvard, Vancouver, ISO, and other styles
23

Karpińska, Kinga, and Anna Protasiewicz. "Patent law and innovations of the Polish economy: Analysis of the current situation and recommendations for the future." Ekonomia 27, no. 4 (February 16, 2022): 63–83. http://dx.doi.org/10.19195/2658-1310.27.4.5.

Full text
Abstract:
One of the key elements of modern economies is their innovation, measured in many ways. The measures of innovation most often include R&D expenditure (expenditure side) and patents (effects side). Undoubtedly, the level of expenditure on research activities is important, but the true picture of an innovative economy is provided by the side of the achieved results, i.e. patents. The purpose of the article is to analyze the impact of patent law (organizational, financial, and legal conditions, and thus the number of filed and patented solutions) on the level of innovativeness on the example of the Polish economy. The analysis was based on a review of domestic and foreign literature and legal acts on patent protection at the national, regional (European) and international levels on the one hand, and innovation in Poland and European countries on the other. To assess the level of innovativeness data from the Global Innovation Index, the Central Statistical Office (GUS) and the European Innovation Scoreboard were used. Comparison of these data made it possible to articulate several conclusions. First, patent law is considered too complex and unclear for research applicants. Moreover, the awareness of patent applicants in Poland is still quite low, especially if the entity is a small enterprise. An undoubted barriers to the patent activity are also the costs that must be borne during the entire patent procedure and the waiting time for the procedure to be completed. Future research should focus on surveying businesses in Poland about their views on patent law and possible changes to improve its operation, allowing for a more detailed analysis of the issue.
APA, Harvard, Vancouver, ISO, and other styles
24

Burra, Ramya, Chandramani Singh, and Joy Kuri. "Service scheduling for random requests with fixed waiting costs." Performance Evaluation, June 2022, 102297. http://dx.doi.org/10.1016/j.peva.2022.102297.

Full text
APA, Harvard, Vancouver, ISO, and other styles
25

Ouyang, Huiyin, Nilay Taník Argon, and Serhan Ziya. "Assigning Priorities (or Not) in Service Systems with Nonlinear Waiting Costs." Management Science, April 29, 2021. http://dx.doi.org/10.1287/mnsc.2020.3952.

Full text
Abstract:
For a queueing system with multiple customer types differing in service-time distributions and waiting costs, it is well known that the cµ-rule is optimal if costs for waiting are incurred linearly with time. In this paper, we seek to identify policies that minimize the long-run average cost under nonlinear waiting cost functions within the set of fixed priority policies that only use the type identities of customers independently of the system state. For a single-server queueing system with Poisson arrivals and two or more customer types, we first show that some form of the cµ-rule holds with the caveat that the indices are complex, depending on the arrival rate, higher moments of service time, and proportions of customer types. Under quadratic cost functions, we provide a set of conditions that determine whether to give priority to one type over the other or not to give priority but serve them according to first-come, first-served (FCFS). These conditions lead to useful insights into when strict (and fixed) priority policies should be preferred over FCFS and when they should be avoided. For example, we find that, when traffic is heavy, service times are highly variable, and the customer types are not heterogenous, so then prioritizing one type over the other (especially a proportionally dominant type) would be worse than not assigning any priority. By means of a numerical study, we generate further insights into more specific conditions under which fixed priority policies can be considered as an alternative to FCFS. This paper was accepted by Baris Ata, stochastic models and simulation.
APA, Harvard, Vancouver, ISO, and other styles
26

Nhung, Vu Cam, and Lai Cao Mai Phuong. "Cost of corruption and efficiency in employment of firms: The case in Vietnam." Accounting, 2021, 609–14. http://dx.doi.org/10.5267/j.ac.2020.12.018.

Full text
Abstract:
This paper examines the impact of corruption on employers' efficiency in Vietnamese firms. The Generalized Least Square (GLS) estimation method was used for data sets surveyed for Vietnamese firms in 63 localities. The research results show that the unofficial costs in the industry and the total informal costs accounting for 10% or more of revenue will negatively affect the labor efficiency of these enterprises. For costs related to administrative procedures, businesses accept to pay these fees in order to save waiting time and it contributes to increase the efficiency of employers in businesses. In addition to the corruption factor, the study also shows that the number of employees, the location of operation, the average value of fixed assets per employee and the return on equity also affect the efficiency of use. employees in Vietnamese enterprises.
APA, Harvard, Vancouver, ISO, and other styles
27

Nhung, Vu Cam, and Lai Cao Mai Phuong. "Cost of corruption and efficiency in employment of firms: The case in Vietnam." Accounting, 2021, 609–14. http://dx.doi.org/10.5267/j.ac.2020.12.018.

Full text
Abstract:
This paper examines the impact of corruption on employers' efficiency in Vietnamese firms. The Generalized Least Square (GLS) estimation method was used for data sets surveyed for Vietnamese firms in 63 localities. The research results show that the unofficial costs in the industry and the total informal costs accounting for 10% or more of revenue will negatively affect the labor efficiency of these enterprises. For costs related to administrative procedures, businesses accept to pay these fees in order to save waiting time and it contributes to increase the efficiency of employers in businesses. In addition to the corruption factor, the study also shows that the number of employees, the location of operation, the average value of fixed assets per employee and the return on equity also affect the efficiency of use. employees in Vietnamese enterprises.
APA, Harvard, Vancouver, ISO, and other styles
28

Long, Zhenghua, Hailun Zhang, Jiheng Zhang, and Zhe George Zhang. "The Generalized c/μ Rule for Queues with Heterogeneous Server Pools." Operations Research, May 17, 2023. http://dx.doi.org/10.1287/opre.2023.2472.

Full text
Abstract:
Dynamic Routing of Queues with Heterogeneous Server Pools In “The Generalized c/μ Rule for Queues with Heterogeneous Server Pools,” Long, Zhang, Zhang, and Zhang study the optimal control of queueing systems with heterogeneous server pools and a single customer class. The goal is to balance the holding cost of the queue with the operating costs of the server pools. They introduce the target-allocation policy, the Gc/μ rule, and the fixed priority policy for systems with general, convex, and concave cost functions, respectively. They also consider an extension to minimize operating costs and maintain a service-level target for customers waiting in the queue. Moreover, they show that their asymptotically optimal routing policies coincide with several classic policies in the literature in special cases.
APA, Harvard, Vancouver, ISO, and other styles
29

Loginova, Oksana. "Competitive Effects of Mass Customization." Review of Marketing Science 10, no. 1 (October 31, 2012). http://dx.doi.org/10.1515/1546-5616.1139.

Full text
Abstract:
Abstract The existing theoretical literature on mass customization maintains that customization reduces product differentiation and intensifies price competition. In contrast, operations management studies argue that customization serves primarily to differentiate a company from its competitors. Interactive involvement of the customer in product design creates an affective relationship with the firm, relaxing price competition. This paper provides a model that incorporates consumer involvement to explain the phenomena described in the operations management literature.Two firms on the Hotelling line compete for a continuum of consumers with heterogeneous brand preferences. An exogenously given fraction of consumers is potentially interested in customization. Consumer benefits from customization are the rewards from a special shopping experience and the value of product customization (a better fitting product); these benefits are higher for consumers located closer to the customizing brand. When a consumer purchases a customized product, he/she incurs waiting costs. Each firm simultaneously decides whether to offer standard products, customized products, or both, and then engage in price competition. I show that customization increases product differentiation, leading to less intense price competition. Depending on the parameter values, in equilibrium either both firms offer customized products, one firm offers customized products and the other standard and customized products, or one firm offers customized products and the other standard products. I perform comparative statics analysis with respect to the fraction of consumers interested in customization, the waiting costs, and the fixed cost of customization.
APA, Harvard, Vancouver, ISO, and other styles
30

Lacowicz, Pedro Giovani, Ricardo Berger, Romano Timofeiczyk Júnior, and João Carlos Garzel Leodoro Da Silva. "MINIMIZAÇÃO DOS CUSTOS DE TRANSPORTES RODOVIÁRIO FLORESTAL COM O USO DA PROGRAMAÇÃO LINEAR E OTIMIZAÇÃO DO PROCESSO." FLORESTA 32, no. 1 (June 30, 2002). http://dx.doi.org/10.5380/rf.v32i1.2350.

Full text
Abstract:
Este trabalho tratou da minimização dos custos do transporte rodoviário florestal, através da programação linear inteira e otimização dos tempos de ciclo de transporte. Após a obtenção dos dados de uma empresa florestal, foram elaborados três cenários, quais sejam: Cenário I: levantamento do quadro atual da empresa, como subsídio comparativo após a racionalização e otimização das etapas que mais consomem tempo do ciclo; Cenário II: realizada em função do uso da programação linear, juntamente com a racionalização dos tempos de fila de espera para carga e descarga; Cenário III: além da programação linear e racionalização dos tempos de espera em fila, utilizou-se, paralelamente, uma otimização do tempo de carga e uma elevação da velocidade de transporte. Os resultados mostraram-se significativos, onde a racionalização e a otimização contribuíram para a redução no número de caminhões e do custo total, traduzindo-se em aumentos na produção dos veículos, na receita bruta e líquida dos freteiros. Cost Minimization of Forest Road Transport by Using the Integer Linear Program and Transport Cycle Time Optimization Abstract This study was about the decreasent of the costs of forest road transport, using the integer linear program and transport cycle time optimization. After obtaining all of the costs, consumed time and the current company picture, a total of three evaluations were done and are described below in settings. Setting I: The current company picture data was calculated as a comparative subsidy following the racionalization and optimization stages that are more time-consuming in the transport cycle. Setting II: This evaluation was done in terms of linear programation use, together with the loading and unloading waiting in line time racionalization. Setting III: In this evaluation, besides the linear programation use and waiting in line time racionalization, it was simultaneously used a time optimization and a foster transport speed. The acquired results were very meaningful, while the racionalization and optimization happened, the trucks rate and total cost successively decreased, resulting in better vehicles performance, and consequently, an increase in the gross and net drivers’ income. Even though there was a costs decrease and an outsiders’ income increase, wich was not enough to pay their total costs, that is, only the variable ones were totally paid and part of the outsiders’ fixed cost.
APA, Harvard, Vancouver, ISO, and other styles
31

Alsdurf, H., B. Empringham, C. Miller, and A. Zwerling. "Tuberculosis screening costs and cost-effectiveness in high-risk groups: a systematic review." BMC Infectious Diseases 21, no. 1 (September 8, 2021). http://dx.doi.org/10.1186/s12879-021-06633-3.

Full text
Abstract:
Abstract Background Systematic screening for active tuberculosis (TB) is a strategy which requires the health system to seek out individuals, rather than waiting for individuals to self-present with symptoms (i.e., passive case finding). Our review aimed to summarize the current economic evidence and understand the costs and cost-effectiveness of systematic screening approaches among high-risk groups and settings. Methods We conducted a systematic review on economic evaluations of screening for TB disease targeting persons with clinical and/or structural risk factors, such as persons living with HIV (PLHIV) or persons experiencing homelessness. We searched three databases for studies published between January 1, 2010 and February 1, 2020. Studies were included if they reported cost and a key outcome measure. Owing to considerable heterogeneity in settings and type of screening strategy, we synthesized data descriptively. Results A total of 27 articles were included in our review; 19/27 (70%) took place in high TB burden countries. Seventeen studies took place among persons with clinical risk factors, including 14 among PLHIV, while 13 studies were among persons with structural risk factors. Nine studies reported incremental cost-effectiveness ratios (ICERs) ranging from US$51 to $1980 per disability-adjusted life year (DALY) averted. Screening was most cost-effective among PLHIV. Among persons with clinical and structural risk factors there was limited evidence, but screening was generally not shown to be cost-effective. Conclusions Studies showed that screening is most likely to be cost-effective in a high TB prevalence population. Our review highlights that to reach the “missing millions” TB programmes should focus on simple, cheaper initial screening tools (i.e., symptom screen and CXR) followed by molecular diagnostic tools (i.e., Xpert®) among the highest risk groups in the local setting (i.e., PLHIV, urban slums). Programmatic costs greatly impact cost-effectiveness thus future research should provide both fixed and variable costs of screening interventions to improve comparability.
APA, Harvard, Vancouver, ISO, and other styles
32

Wohlin, Jonas, Clara Fischer, Karin Solberg Carlsson, Sara Korlén, Pamela Mazzocato, Carl Savage, Holger Stalberg, and Mats Brommels. "As predicted by theory: choice and competition in a publicly funded and regulated regional health system yield improved access and cost control." BMC Health Services Research 21, no. 1 (May 1, 2021). http://dx.doi.org/10.1186/s12913-021-06392-6.

Full text
Abstract:
Abstract Background New Public Management (NPM) has been widely used to introduce competition into public healthcare. Results have been mixed, and there has been much controversy about the appropriateness of a private sector-mimicking governance model in a public service. One voice in the debate suggested that rather than discussing whether competition is “good” or “bad” the emphasis should be on exploring the conditions for a successful implementation. Methods We report a longitudinal case study of the introduction of patient choice and allowing private providers to enter a publicly funded market. Patients in need of hip or knee replacement surgery are allowed to choose provider, and those are paid a fixed reimbursement for the full care episode (bundled payment). Providers are financially accountable for complications. Data on number of patients, waiting lists and times, costs to the public purchaser, and complications were collected from public registries. Providers were interviewed at three points in time during a nine-year follow-up period. Time-series of the quantitative data were exhibited and the views of actors involved were explored in a thematic analysis of the interviews. Results The policy goals of improving access to care and care quality while controlling total costs were achieved in a sustained way. Six themes were identified among actors interviewed and those were consistent over time. The design of the patient choice model was accepted, although all providers were discontent with the level of reimbursement. Providers felt that quality, timeliness of service and staff satisfaction had improved. Public and private providers differed in terms of patient-mix and developed different strategies to adjust to the reimbursement system. Private providers were more active in marketing and improving operation room efficiency. All providers intensified cooperation with referring physicians. Close attention was paid to following the rules set by the purchaser. Discussion and conclusions The sustained cost control was an effect of bundled payment. What this study shows is that both public and private providers adhere long-term to regulations by a public purchaser that also controls entrance to the market. The compensation was fixed and led to competition on quality, as predicted by theory.
APA, Harvard, Vancouver, ISO, and other styles
33

Gomes, Yolanda E., Minh Chau, Helen A. Banwell, and Ryan S. Causby. "Diagnostic accuracy of the Ottawa ankle rule to exclude fractures in acute ankle injuries in adults: a systematic review and meta-analysis." BMC Musculoskeletal Disorders 23, no. 1 (September 23, 2022). http://dx.doi.org/10.1186/s12891-022-05831-7.

Full text
Abstract:
Abstract Background Ankle traumas are common presenting injuries to emergency departments in Australia and worldwide. The Ottawa Ankle Rules (OAR) are a clinical decision tool to exclude ankle fractures, thereby precluding the need for radiographic imaging in patients with acute ankle injury. Previous studies support the OAR as an accurate means of excluding ankle and midfoot fractures, but have included a paediatric population, report both the ankle and mid-foot, or are greater than 5 years old. This systematic review and meta-analysis aimed to update and assess the existing evidence of the diagnostic accuracy of the Ottawa Ankle Rule (OAR) acute ankle injuries in adults. Methods A systematic search and screen of was performed for relevant articles dated 1992 to 2020. Prospective and retrospective studies documenting OAR outcomes by physicians to assess ankle injuries were included. Critical appraisal of included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Outcomes related to psychometric data were pooled using random effects or fixed effects modelling to calculate diagnostic performance of the OAR. Between-study heterogeneity was assessed using the Higgins I2 test, with Spearman’s correlation test for threshold effect. Results From 254 unique studies identified in the screening process, 15 were included, involving 8560 patients from 13 countries. Sensitivity, specificity, negative likelihood ratio, positive likelihood ratio and diagnostic odds ratio were 0.91 (95% CI, 0.89 to 0.92), 0.25 (95% CI, 0.24 to 0.26), 1.47 (95% CI, 1.11 to 1.93), 0.15 (95% CI, 0.72 to 0.29) and 10.95 (95% CI, 5.14 to 23.35) respectively, with high between-study heterogeneity observed (sensitivity: I2 = 94.3%, p < 0.01; specificity: I2 = 99.2%, p < 0.01). Most studies presented with low risk of bias and concern regarding applicability following assessment against QUADAS-2 criteria. Conclusions Application of the OAR is highly sensitive and can correctly predict the likelihood of ankle fractures when present, however, lower specificity rates increase the likelihood of false positives. Overall, the use of the OAR tool is supported as a cost-effective method of reducing unnecessary radiographic referral, that should improve efficiency, lower medical costs and reduce waiting times.
APA, Harvard, Vancouver, ISO, and other styles
34

Hourvitz, A., S. Reuvenny, A. Luz, R. Hourvitz, M. Baum, M. Youngster, and E. Maman. "P-664 Optimizing IVF unit workload by balancing retrievals using artificial intelligence algorithm for trigger day decision." Human Reproduction 38, Supplement_1 (June 1, 2023). http://dx.doi.org/10.1093/humrep/dead093.990.

Full text
Abstract:
Abstract Study question Can an algorithm effectively reduce fluctuations in the number of retrievals per day by distributing them more evenly throughout the month without compromising clinical outcome? Summary answer A trigger day decision algorithm can evenly distribute retrievals throughout the month, significantly reducing the variations of retrievals per day, without compromising clinical outcome. What is known already Whether clinic workload can have an impact on IVF outcomes is controversial with some studies indicating that high procedure volume may lead to lower pregnancy rates. Furthermore, efficient workload management is crucial for fertility clinics to achieve optimal outcomes for both patients and staff. Overwhelming workloads can lead to staff burnout and decreased productivity. Clinics need to be cautious with the number of patients they treat due to the fluctuations in the number of retrievals. Reducing these fluctuations can help the clinic maintain stability in patient flow, reduce waiting lists, and enhance overall efficiency and productivity. Study design, size, duration A retrospective cohort study including data of 6,562 retrieval protocol cycles performed in a large center serving over 50 physicians, between November 2021 and October 2022. The data includes 5,377 (81.94%) antagonist protocol cycles and 1,185 (18.06%) cycles of different protocols. The antagonist protocol cycles also include information on suggested trigger options: a specific single day, two options or three optional days, which were determined by a trigger management algorithm. Participants/materials, setting, methods An algorithm was developed to evenly distribute retrievals throughout the month. It divides the cycles into two groups: those with one suggested trigger day and fixed retrieval day (4,730 cycles 72.08%), and those with two/three suggested trigger day options and flexibility in choosing retrieval day (1,832 cycles 27.92%). The algorithm first allocates cycles with two options and then cycles with three options, aiming to minimize the variation in the number of retrievals between days. Main results and the role of chance The study showed that the implementation of a balancing algorithm on a clinic with an average of 18 retrievals per day resulted in a decrease of the standard deviation of the number of retrievals per day, from an average of 7.66 to 3.16, narrowing the range (average ± 2 standard deviation) of daily activity from 3-33 to 12-24 daily retrievals. Furthermore, the study showed that the number of days with more than 150% or less than 50% retrievals than the average of the month, decreased significantly from an average of 8.4 days per month to 0.5 day per month when the balancing algorithm was applied. Assuming the clinic has the capacity to handle the previous upper range of daily retrievals, the implementation of the balancing algorithm reduced the standard deviation and allowed for an increase in the average number of daily retrievals by approximately 31%, to an average of 23.6 cycles per day, with the clinic's capacity remaining unchanged. Limitations, reasons for caution This algorithm was developed specifically for antagonist cycles, which comprise approximately 80% of retrievals. Therefore, it cannot be applied to about 20% of cycles that are limited to a fixed trigger day but may have similar flexibility when an algorithm is available. Wider implications of the findings The use of a balancing algorithm has the potential to reduce workload and improve efficiency for medical and laboratory staff, thereby reducing errors and costs. Furthermore, it may enable clinics to treat more patients using the same facilities and resources, thus decreasing waitlists for treatments. Trial registration number HMC-0011-22
APA, Harvard, Vancouver, ISO, and other styles
35

Löffler, Maximilian, Nils Boysen, and Michael Schneider. "Picker Routing in AGV-Assisted Order Picking Systems." INFORMS Journal on Computing, August 23, 2021. http://dx.doi.org/10.1287/ijoc.2021.1060.

Full text
Abstract:
To reduce unproductive picker walking in traditional picker-to-parts warehousing systems, automated guided vehicles (AGVs) are used to support human order pickers. In an AGV-assisted order-picking system, each human order picker is accompanied by an AGV during the order-picking process. AGVs receive the picked items and, once a picking order is complete, autonomously bring the collected items to the shipping area. Meanwhile, a new AGV is requested to meet the picker at the first storage position of the next picking order. Thus, the picker does not have to return to a central depot and continuously picks order after order. This paper addresses both the routing of an AGV-assisted picker through a single-block, parallel-aisle warehouse and the sequencing of incoming orders. We present an exact polynomial time routing algorithm for the case of a given order sequence, which is an extension of the algorithm of Ratliff and Rosenthal [Ratliff HD, Rosenthal AS ( 1983 ) Order-picking in a rectangular warehouse: A solvable case of the traveling salesman problem. Oper. Res. 1(3):507–521], and a heuristic for the case in which order sequencing is part of the problem. In addition, we investigate the use of highly effective traveling salesman problem (TSP) solvers that can be applied after a transformation of both problem types into a standard TSP. The numerical studies address the performance of these methods and study the impact of AGV usage on picker travel: by using AGVs to avoid returns to the depot and by sequencing in (near-) optimal fashion, picker walking can be reduced by about 20% compared with a traditional setting. Sharing AGVs among the picker workforce enables a pooling effect so that, in larger warehouses, only about 1.5 AGVs per picker are required to avoid picker waiting. Summary of Contribution: New technologies, such as automatic guided vehicles (AGVs) are currently considered as options to increase the efficiency of the order-picking process in warehouses, which is responsible for a large part of operational warehousing costs. In addition, picker-routing decisions are more and more often based on algorithmic decision support because of their relevance for decreasing unproductive picker walking time. This paper addresses both aspects and investigates routing algorithms for AGV-assisted order picking in parallel-aisle warehouses. We present a dynamic programming routine with polynomial runtime to solve the problem variant in which the sequence of picking orders is fixed. For the variant in which this sequence is a decision, we show that the problem becomes NP-hard, and we propose a greedy heuristic and investigate the use of state-of-the-art exact and heuristic traveling salesman problem solution methods to address the problem. The numerical studies demonstrate the effectiveness of the algorithms and indicate that AGV assistance promises strong improvements in the order-fulfillment process. Because of the practical relevance of AGV-assisted order picking and the presented algorithmic contributions, we believe that the paper is relevant for practitioners and researchers alike.
APA, Harvard, Vancouver, ISO, and other styles
36

Hawkes, Martine. "What is Recovered." M/C Journal 11, no. 6 (October 14, 2008). http://dx.doi.org/10.5204/mcj.92.

Full text
Abstract:
Saidin Salkić is a survivor of Bosnia’s 1995 Srebrenica genocide. Salkić was interviewed on the Australian Broadcasting Commission’s Radio National in July 2007. The interviewer asked Salkić to tell him about the genocide: “What can you remember about that?” (ABC Radio National). Salkić cited memories of the smell of his father’s jumper and of the flowers growing in his mother’s garden. The interviewer interrupted him, asking for a more chronological description of the events of the genocide itself. Salkić responded that it was not possible to answer the question in such a concise, easily archivable manner, that “you can’t really bundle your memories like that” (ABC Radio National).Listening to this interview, I sat waiting for a neat ‘survivor sound-bite’ that I could neatly insert into this paper. It didn’t happen. I turned off the radio thinking that I had learned nothing of the genocide that took place in Srebrenica. In listening to a survivor—an eye witness—there is a sense that he, of all people, should be able to tell the chronology, the facts of the event; of who did what to whom and why. Yet what is learned—what Salkić’s testimony-without-testimony spoke of and explained—is the most important thing: loss. This is the lacuna in testimony. What happens to the loss when we attempt to testify to it? What is then lost? Salkić’s memory is unarchivable in the normative sense, and his refusal to testify in the accepted way ruptures the process (not a necessarily deliberate refusal, but a refusal borne out of an inability and an impossibility of containing such an event through language). Loss eludes testimony and is also loss as the loss of testimony. It is impossible to fully testify to loss, and that is testimonial, or testimony’s trace.Using Derrida's theories around the archive and the cinder, this article examines what survives an event such as genocide, what is left and, crucially, what is missing, what is not recoverable. What happens to the loss when we attempt to testify to it, to salvage something of it? What is disrupted? What is instead recovered in its place?Derrida’s archive (Derrida, Archive Fever), responds to these gaps and losses. This archive is not, it would seem, about the archive at all. Instead, Derrida provides a departure from the examination of the structure and institution of the archive. As Carolyn Steedman puts it in her reading of Archive Fever, “it turned out not to be about the archival turn. It is about dust.” (Steedman ix) This “dust”, this prelude to the ash, to the cinder, is the search for what is not there, for what is barely visible but at the same time, viscous and residual; the dust which coats and conceals no matter how well you have wielded the duster. For Derrida the dust he has found in the archive is both a meditation on beginnings and on the “fever”. He reflects not on the archive, then, but on that which drives (and destroys) the archive. Derrida’s description of prayer is a way of approaching an understanding of how a memory such as Salkić’s—at once unarchivable, yet crucial to our comprehension of the event, might fit into an understanding of the archive. Derrida writes,“My way of praying, if I pray, is absolutely secret. Even if [I were] in a synagogue praying with others, I know that my own prayer would be silent and secret, and interrupting something in the community” (On Religion). Is it impossible to archive memories such as Salkić’s because his is an impenetrable recollection that disrupts the broader archive? Why do we desire that the archive archives? Why do we desire that the archive recovers, documents and makes public these excruciatingly private moments? The ultimate secret, private and silent moment of death is made loud and public in the archives of genocide. The tendency is to want archives to show the individual, the human being amongst the tangle of anonymous bodies with whom we can identify. But in laying their death and their life bare (indeed in laying their death and life bare through the act of showing their death and life), their privacy and secret is disclosed. Their final privacy in a public death. This is death that is made public through its interconnectedness to the other simultaneous deaths around it. This is also a death that, through its place in a broader history, becomes disconnected from the individual. Finally, it is also a death that has come about through the choice made by someone else that this is your moment and mode of death. I wish to look again at Derrida when he writes that his prayer, though silent and secret, is “interrupting something in the community” (On Religion). Salkić’s memory, too, interrupts. It causes a rupture in what an archive is perceived to be and remains unarchivable. It interrupts our process, yet it cannot be disregarded. Salkić’s memory of his parents is at first seemingly of minor importance in establishing an historical truth as to what occurred in Srebrenica, yet what he has remembered is the loss, the impossibility of remembering, of salvaging this event intact for another audience. If Salkić had presented a readily archivable memory of Srebrenica—a logical and coherent sound bite—would it have a place in the archive? Is such a memory recoverable? Would it be a memory and experience hidden by the formulaic style of historical memory? As it is, Salkić’s memory ruptures the archive. It reveals those dusty spots of the event that our duster cannot reach. It is this dust that removes our certainty, our hope in the archive as a provider of answers and as a clean receptacle for the truth (this whole truth). “Suspension of certainty is part of the prayer” (Derrida, On Religion). We must suspend our certainty in the archive and it is this uncertainty that drives us to keep looking, to keep asking, to keep collecting. To know that we cannot know. To know that we can never have a complete archive. Derrida speaks of the “hopelessness of prayer” (On Religion). The hopelessness of the archive lies in its inability to ever provide a complete or conclusive story and it is this hopelessness that is also driving the archive. I think that the archive should contain these dusty spots that reveal rather than conceal.Still we, the archivists of other people’s memories, fear inconclusivity and complication in the archive. We do not wish to suspend our certainty. Still we assume that through an archive we can fully hold an event. The interviewer will always interrupt Salkić’s memory, demanding the full account, the complete archive, as though such a thing were possible. Still our archive privileges and still then, our archive is hopeless. Other genocides are ignored even as they occur, filed still further back, yet the dust is not going anywhere. Even when it fully coats and conceals an event, the dust lends the event and its memories form and marks their non/presence.Maybe, then, the archive in its presumed weight is no more than a skin, “the glosses on the edge of the abyss” (Derrida, The Politics of Friendship 143), giving a thin layer of protection and concealment. It is the losses and exclusions (those scarred and phantom limbs) that urge us to look further. To know, then, the archive as Foucault’s “unstable assemblage of faults, fissures and heterogeneous layers” (146). So what, then? How do we reconcile ourselves with or even begin our recovery of the scarred and phantom limbs? (Do they even want to be found? Are they even there?) This is Derrida’s dilemma of “How to watch over something that one can, however, neither watch over, nor assimilate, nor internalise, nor categorise” (For What Tomorrow…A Dialogue 138).Yet these testimonies (such as Salkić’s) are disallowed. They rupture with their silence. The archive cannot contain such testimony. Perhaps this goes some way to explaining why testimony cannot be codified. The silence, after all, cannot in itself offer any hint or clue towards a complete testimony. The silence cannot provide an archiving system into which Salkić’s memory might be deposited or neatly filed. Instead the silent cinder marks an acknowledgment of the difficulty of representation and of defining an experience by way of collectivity or of representing trauma in a coherent survivor sound-bite.These are the Derridean cinders of the event. The cinders are not the event—the originary sound or moment—itself. They are the ashes of this. To try and contain, conclude and comprehend the event itself through its ashes—through the bare artefacts it leaves behind—is to try to comprehend something that is ungraspable and unknowable. Derrida writes, “The cinder is not, is not what is. It remains from what is not, in order to recall the delicate, charred bottom of itself only non-being or non-presence” (Derrida, Cinders 39). Yet he continues, “Cinders remain. Cinder there is.”This is the fragility of the cinder, smothering and concealing the secret before it reaches us, translating it from language into unreadable ash. Was it ever really with us or on its way to meet us? This is “not some sort of conditional secret that could be revealed, but the secret that there is no secret, that there never was one, not even one” (Caputo 109). Turning to Salkić’s memories, I wonder if there is anything there other than an amnesiac or uncooperative guest/ghost? Maybe I wrote his words down incorrectly in my initial dismissal? Or maybe the memories are, in their incompleteness, in the interrupted gaps, telling us a secret? That there is none. That it is ineffable, not some secret waiting to be whispered, intact, in our ear. That nothing is fully recoverable from such an event and that it is the very unrecoverability that tells all that is important to know of the event. The fire has burned and consumed its beginnings and its event, leaving only ash, cinder, behind as a trace. As it is a cindered trace, it differs from other traces in its unchartability. It is not possible to follow the flyaway cinders back to an event as the cinders are not markers, but remains: “the body of which cinders is the trace has totally disappeared, it has totally lost its contours, its form, its colours, its natural determination” (Derrida, Points 391). In genocide, people have been killed, raped, disappeared, removed, displaced. The cinders that remain are unidentifiable and undetermined, but it is this presence of non-presence that remains. This is the invisible presence of the loss. Unlike a footprint, the cinder cannot be followed, cannot be recovered. It is a trace which “remains without remaining, which is neither present nor absent, which destroys itself, which is totally consumed, which is a remainder without remainder. That is, something which is not” (Derrida, Points 208). So what light can Derrida’s dusty cinder possibly shed on the archival responses to genocide? In its marking and coating of the various impossibilities and losses within the archive, the cinder makes certain aspects more visible. If not visible, then perhaps sensed as one senses smoke. Let us consider the romantic imagining of a library and the role that dust plays in such an imagining. The dust swirls around, leaving shiny absences while also settling heavily on certain shelves. This is a revealing dust, a dust which marks time, marking the losses and forgettings, rendering the absences and difficulties within the archive not so much wholly visible, as visible through their invisibility. This is the invisible smoke that fogs the glass and sneaks under the velvet rope. We invoke the call to never again (“and again, and again, and again” echoes Homi K Bhabha), we mark remembrance days, we watch trials from behind the glass in polite institutionalised silence, we remember only the dead and the time, we build memorials and establish courts, we write dissertations and publish our articles, we cram the impossible nothing – what we imagine to be empty space – full of language and debate. But what do these lives and losses mean? What depth and weight is in the emptiness, the silence, the secret? Cinders persist. Cinders mark the lacuna and the space for the silence and silenced. The cinder, the burned remains of language, provides no way of telling or testifying. The cinders, in marking the difficulty of representation, also mark the exclusion and loss of certain voices within the archive. To see the cinder as a provision of a lens through which to view absences is a fragile vision. Yet, within the cinder is an impression of a figure (the hints and remains of a burned moment; that which was but no longer is). In the cinder’s very presence, in its non-presence, this entails and implies an absence. The event “immediately incinerates itself, in front of your eyes: an impossible mission” (Derrida, Cinders 35). This impossible mission, though, contains a possibility in the gap, the space that is left. There is no longer the physical support of the form; we are left with a grey shapeless ash, as “everything is annihilated in the cinders” (Derrida, Points 391). While the event has totally lost the trace of itself in its incineration, what rises (dare I say phoenix-like) from the ash is the choking shapelessness of a loss. A loss that defies and confounds the archive. Yet how can the cinder, the ash marking the gaps, the silence, the ghostly secret, be incorporated into testimony and the testimonial gathering modes? Can such testimonies be codified? Agamben’s thoughts, through ‘Remnants of Auschwitz: The Witness and the Archive’ are crucial in this respect in contemplating the im/possibility of gaining a complete testimony and of the necessity of the lacuna in all testimony. Agamben writes of the absence of the complete witness to the event through analogy: “Just as in the expanding universe, the furthest galaxies move away from us at a speed greater than that of their light, which cannot reach us, such that the darkness we see in the sky is nothing but the invisibility of the light of unknown stars, so that the complete witness […] is the one we cannot see.” (161 – 162). It is precisely the one who cannot testify, who is silent and silenced, who is the complete witness. And it precisely because of this that the incorporation of the cinder—the act of pinning down the ash—is perhaps impossible to approach within the archive. I borrow here Primo Levi’s example cited by Agamben. Levi, a survivor of Auschwitz amongst other things, writes of a child in Auschwitz called Hurbinek who repeats the word mass-klo or perhaps matisklo to himself, but the meaning of the word remains secret. Levi writes of the child that, “nothing remains of him: he bears witness through these words of mine” (38). The word becomes the cinders of the lacuna represented in Levi’s archive—in his testimony. Agamben writes that, “this means that testimony is the disjunction between two impossibilities of bearing witness; it means that language, in order to bear witness, must give way to a non-language in order to show the impossibility of bearing witness” (39). In order to give this sound to the event—to see its shadow and hear its silence, we must remove our reliance on the “sun”—on having the remembering done for us through didactic monuments and museums. This brings to mind, in this impossible incorporation, the designated “Void Space” at the Jüdisches Museum in Berlin. The Jüdisches Museum in Berlin is something of a perfect archive. The “Void Space” is where the missing elements might be felt. Standing in the void, I felt something of the loss and the claustrophobia that is only possible in a large, dark, empty space shut in by a heavy handle-less door. However, if I had walked through the door and into this void without knowing what it was, I would most likely have backed out, thinking that I had made a mistake; that this space wasn’t part of the museum. Instead, it is a designated void. It is an incredibly effective and affective space, but it is still an ordered, designated, planned space. I can almost hear the planning meeting: “over here in the South Wing, that’s where we’ll put the loss.” Here, the cinder element, that missing part, is given space. Yet, in its provision here in this museum space, the ash is cooled. In its designation as such a space—its permanence and uniformity—something of the cinder is extinguished and its fragility is lost: “if you entrust it to paper, it is all the better to inflame you with” (Derrida, Cinders 53).The cinder should instead reconfigure the very structures of our responses; the way we consider the structure of the archive itself. The cinder marks the impossibility. It must be external to the current representation. It cannot be incorporated. Nothing can be built from the cinder; no Phoenix can rise from it, nothing recognisable in it or from it. To sanction it and offer it “space” would remove its purpose, strip it of its ashes, it “remains unpronounceable in order to make saying possible although it is nothing” (Derrida, Cinders 73).However, in these cinders and their draughts, we are left with crucial refutations. There is a something here that defies the archive, which defies the reductions and exclusions, which defies those attempts to “burn everything” (holos caustos), to destroy all through the act of genocide itself. This is a haunting. In the cinderless archive, in the interrupting and limiting of Salkić’s testimony, we “have gone so fast as to be unaware of its existence” (Derrida, The Politics of Friendship 194). We rush to conclude, comprehend and contain, and in our rush, we miss the patient cinder and we do not feel its haunting. However, should we show our own patience (the patience of a cinder), we would find the (necessarily) unending task of comprehending genocide, and find there something “troubling enough to become unforgettable to the point of obsession” (Derrida, The Politics of Friendship 194).This is the hope in and for the archive as a means of wrestling with the crises of response presented by genocide, and brings my call for openness and dialogue with and of the archive. The cinder recovered from the event, rather than being a philosophical whimsy, marks that which has been lost or silenced or forgotten through the archive in its current structure. The archive as it stands has become, to borrow Zournazi’s thoughts on hope, “self enclosed and the exchange becomes a kind of monologue, a type of depression and narcissism where territories are defended and the stakes raised are already known” (Zournazi 12). Cinders are the hope in the archive. They are also a dangerous, gamblers hope in which the outcomes remain unknown. They are that which has been burned, which can no longer exist in (or bear any resemblance to) the original form, but which persist nonetheless, disrupting the known entities of the archive with dust, the promise of a secret. A secret which can never be told, but that is hope. This is a hope which, as the unearthed remains of a skeleton described by Linda Marie Walker, haunts, just as a cinder might: “The remains, in their haunting, were giving, or opening, a space for thought and a dreaming of past presence.” Hope caught in a cinder, made airborne. Hope that is recovered intact from the event. Hope that these spaces and gaps in the archive, marked by the cinder, might not descend into either a hopeless disengagement nor a retreat into useless and futile rage in the face of genocide and its informing debates. Hope instead that the archive might be turned from a monologue of certainty into an engagement, an exchange, a constant uncertain questioning. A sense that there is no cool remove from genocide and that to attempt to contain it is to do damage to the memory. I end with a quote from Primo Levi in his short story on the element of carbon, which comes at the end of The Periodic Table. This atom of carbon that Levi attempts to describe, and of which “every verbal description must be inadequate” (227), is also the cinder. It is invisible to the eye, it is unpronounceable, but it coats everything. And without its presence we are and we have recovered nothing: “So it happens that every element says something to someone (something different to each) like the mountain valleys or beaches visited in youth. One must perhaps make an exception for carbon, because it says everything to everyone” (Levi 225).The dependence on and domination of archives which have at their core an aim of concluding, comprehending and containing an event, denies the necessary complexity and incomprehensibility of stories such as Salkic’s. There is a risk here of forgetting that such complex stories, such incomplete memories—like carbon itself—speak to the essence of what it is to be human and what it is to have lost. ReferencesABC Radio National. “Kasedevah Blues.” Life Matters. 26 July 2007.Agamben, Giorgio. Remnants of Auschwitz: The Witness and the Archive. New York: Zone Books, 2002.Bhabha, Homi K. “Keynote Speech: On Global Memory, Reflections on Barbaric Traditions.” Reimagining Asia Conference and Exhibition, Haus der Kulturen der Welt: Berlin, 14 March 2008.Caputo, John D. The Prayers and Tears of Jacques Derrida: Religion without Religion. Bloomington, Indiana: Indiana Press, 1997.Derrida, Jacques and Elisabeth Roudinesco. For What Tomorrow: A Dialogue. Stanford, California: Stanford University Press, 2004.———. On Religion. Toronto: Society of Biblical Literature Annual Meeting, 2002.———. The Politics of Friendship. London, New York: Verso, 1997.———. Archive Fever: A Freudian Impression. Chicago and London: The University of Chicago Press, 1996.———. Points...Interviews, 1974-1994. Stanford, California: Stanford University Press, 1995.———. Cinders. Lincoln and London: University of Nebraska Press, 1991.Foucault, Michel. “Nietzsche, Genealogy, History.” Language, Counter-Memory, Practice: Selected Essays and Interviews, Ed. D. F. Bouchard. Ithaca: Cornell University Press, 1977.Levi, Primo. The Periodic Table. London: Abacus Books, 1986.Walker, Linda Marie. “The Archaeology of Surfaces, or What Is Left Moment to Moment, or I Can’t Get over It.” An Archaeology of Surface(s). (2003). 20 Dec. 2007 ‹http://ensemble.va.com.au/lmw/surface/surfacenotes.html›.Zournazi, Mary. Hope: New Philosophies for Change. Australia: Pluto Press, 2002.
APA, Harvard, Vancouver, ISO, and other styles
We offer discounts on all premium plans for authors whose works are included in thematic literature selections. Contact us to get a unique promo code!

To the bibliography