Interest of D-dimer level,severity of COVID-19 and cost of management in Gabon

BACKGROUND Coronavirus disease 2019(COVID-19)is strongly associated with an increased risk of thrombotic events,including severe outcomes such as pulmonary embolism.Elevated D-dimer levels are a critical biomarker for assessing this risk.In Gabon,early implementation of anticoagulation therapy and D-dimer testing has been crucial in managing COVID-19.This study hypothesizes that elevated Ddimer levels are linked to increased COVID-19 severity.AIM To determine the impact of D-dimer levels on COVID-19 severity and their role in guiding clinical decisions.METHODS This retrospective study analyzed COVID-19 patients admitted to two hospitals in Gabon between March 2020 and December 2023.The study included patients with confirmed COVID-19 diagnoses and available D-dimer measurements at admission.Data on demographics,clinical outcomes,D-dimer levels,and healthcare costs were collected.COVID-19 severity was classified as non-severe(outpatients)or severe(inpatients).A multivariable logistic regression model was used to assess the relationship between D-dimer levels and disease severity,with adjusted odds ratios(OR)and 95%CI.RESULTS A total of 3004 patients were included,with a mean age of 50.17 years,and the majority were female(53.43%).Elevated D-dimer levels were found in 65.81%of patients,and 57.21%of these experienced severe COVID-19.Univariate analysis showed that patients with elevated D-dimer levels had 3.33 times higher odds of severe COVID-19(OR=3.33,95%CI:2.84-3.92,P<0.001),and this association remained significant in the multivariable analysis,adjusted for age,sex,and year of collection.The financial analysis revealed a substantial burden,particularly for uninsured patients.CONCLUSION D-dimer predicts COVID-19 severity and guides treatment,but the high cost of anticoagulant therapy highlights the need for policies ensuring affordable access in resource-limited settings like Gabon.

Estimation of the Direct Cost of Management of Venous Thromboembolism in Three Reference Hospitals in the City of Yaoundé: A Retrospective Study over a Three-Year Period

Background: Venous thromboembolism (VTE) is a major public health problem due to its increasing frequency, mortality and management cost. This cost may require major financial efforts from patients, especially in developing countries like ours where less than 7% of the population has health insurance. This study aimed to estimate the direct cost of managing VTE in three reference hospitals in Yaoundé. Methods: This was a cross-sectional retrospective study over a three-year period (from January 1st 2018 to December 31 2020) carried out in the Cardiology departments of the Central and General Hospitals, and the Emergency Centre of the city of Yaoundé. All patients managed during the study period for deep vein thrombosis and pulmonary embolism confirmed by venous ultrasound coupled with Doppler and computed tomography pulmonary angiography respectively were included. For each patient, we collected sociodemographic and clinical data as well as data on the cost of consultation, hospital stay, workups and medications. These data were analysed using SPSS version 23.0. Results: A total of 92 patient’s records were analysed. The median age was 60 years [48 - 68] with a sex ratio of 0.53. The median direct cost of management of venous thromboembolism was 766,375 CFAF [536,455 - 1,029,745] or $1415 USD. Management of pulmonary embolism associated with deep vein thrombosis was more costly than isolated pulmonary embolism or deep vein thrombosis. Factors influencing the direct cost of management of venous thromboembolism were: hospital structure (p = 0.015), health insurance (p 0.001), type of pulmonary embolism (p = 0.021), and length of hospital stay (p = 0.001). Conclusion: Management of VTE is a major financial burden for our patients and this burden is influenced by the hospital structure, health insurance, type of pulmonary embolism and length of hospital stay.

The Application of Transaction Cost Theory in Supply Chain Management

In the context of globalization and digitalization, the application of transaction cost theory in supply chain management has become increasingly important. As business environments grow more complex, enterprises face challenges in effectively managing supply chain transaction costs. This paper systematically explores the application of transaction cost theory in supply chain management, covering key areas such as supplier selection, supply chain integration, and risk management. The research finds that supplier evaluation models based on transaction costs can help enterprises make more comprehensive selection decisions. In terms of supply chain integration, transaction cost theory provides important guidance for vertical integration decisions and the design of collaboration mechanisms. The application of digital technologies has both reduced traditional transaction costs and introduced new cost considerations. Faced with emerging risks such as cybersecurity and geopolitical issues, enterprises need to adopt dynamic transaction cost management strategies. In the future, the application of transaction cost theory in supply chain management will likely place greater emphasis on interdisciplinary integration and sustainable development, providing theoretical support for enterprises to achieve efficient, flexible, and sustainable supply chain management in the changing global business environment.

Analysis of the Current Situation of Cost Management and Control of Highway Construction Projects

The highway engineering process is complex,coupled with a relatively long construction period,hence requires increased coordination between participating units to prevent economic disputes and efficiency losses.The main body of the construction project needs to strengthen the management and control of funds.In this regard,this paper analyzes the importance of cost management in highway projects by clarifying and analyzing the current cost management status quo problems and causes.The highway engineering cost control strategy and implementation methods are summarized to provide references for improving the quality of highway engineering.

Whole-Process Project Cost Management Based on Building Information Modeling (BIM)

The whole-process project cost management based on building information modeling(BIM)is a new management method,aiming to realize the comprehensive optimization and improvement of project cost management through the application of BIM technology.This paper summarizes and analyzes the whole-process project cost management based on BIM,aiming to explore its application and development prospects in the construction industry.Firstly,this paper introduces the role and advantages of BIM technology in engineering cost management,including information integration,data sharing,and collaborative work.Secondly,the paper analyzes the key technologies and methods of the whole-process project cost management based on BIM,including model construction,data management,and cost control.In addition,the paper also discusses the challenges and limitations of the whole-process BIM project cost management,such as the inconsistency of technical standards,personnel training,and consciousness change.Finally,the paper summarizes the advantages and development prospects of the whole-process project cost management based on BIM and puts forward the direction and suggestions for future research.Through the research of this paper,it can provide a reference for construction cost management and promote innovation and development in the construction industry.

Research on Contract Management and Control in the Process of Project Cost

In the current economic situation, strengthening the contract management of the construction cost has a beautifully role. At the same time, according to construction project cost management, the scientific management of the contract, can promote the reasonable and balanced investment cost allocation in the quality and safety and other aspects of the project, so that the construction project can obtain higher added value, and to further promote China＇ s economic construction and accelerate the pace of the city. This paper first briefly elaborates our construction project cost of the contract management on the present situation, and some problems are analyzed and discussed, and then puts forward some suggestions on the measures and countermeasures for cost management of construction engineering contract.

Crystallization management of CsPbI_(2)Br perovskites by PbAc_(2)-incorporated twice spin-coating process for efficient and stable CsPbI_(2)Br perovskite solar cells

CsPbI_(2)Br perovskite solar cell has been extensively studied due to its exceptional thermal stability and relatively stable perovskite phase structure.However,the presence of bromine leads to a rapid crystallization rate of CsPbI_(2)Br films,resulting in small grain size and high defect density.Additionally,CsPbI_(2)Br demonstrates poor light absorption due to its wide bandgap.Therefore,it is crucial to control the crystallization rate and increase the film thickness to reduce defect density,enhance light absorption,and improve photovoltaic performance.In this study,we utilized a PbAc_(2)-incorporated twice spincoating(PTS) process to address these issues.Initially,PbAc_(2) was added to the CsPbI_(2)Br precursor solution to form a CsPbI_(2)Br film,which was then coated with the CsPbI_(2)Br precursor solution to produce the PTS film,Ac^(-)can delay the perovskite crystallization,leading to the formation of thicker and denser CsPbI_(2)Br films.Moreover,lone-pair electrons of the oxygen atom provided by Ac^(-)formed coordination bonds with under-coordinated Pb~(2+) ions to fill halogen ion vacancies,thereby reducing the defect density.Ultimately,the PTS CsPbI_(2)Br device achieved a peak power conversion efficiency(PCE) of 16.19% and maintained 96.7% of its initial PCE over 1500 h at room temperature under 25% relative humidity without any encapsulation.

Development and Application of Procedures for the Management of Skin Toxicity Related to Immune Checkpoint Inhibitors in Patients with Lung Cancer

Objective: To establish the procedures for the management of skin toxicity related to immune checkpoint inhibitors in patients with lung cancer and explore the effect of application. Methods: A total of 24 evidence-based evidences were collected from 7 aspects, including risk factors, baseline screening, ICIs monitoring, daily skin care, multidisciplinary management, symptom management and health education. A total of 157 lung cancer patients and 94 nurses from 8 wards of the Oncology department of our hospital from November 2022 to May 2023 were selected by convenience sampling. A total of 77 patients and 46 nurses from ward 1 - 4 were divided into the baseline group. There were 80 patients and 48 nurses in Ward 5 - 8 as the evidence-based practice group. In the baseline group, patients were treated with routine methods such as assessing skin symptoms, taking medication according to symptoms, guiding to keep skin clean and moist, eating a light diet, and avoiding scratching. The evidence-based practice group adopts an evidence-based continuous improvement model for nursing. The differences in the severity of symptoms of skin toxicity in the second cycle of medication and the knowledge and practice of self-care of skin toxicity were compared between the two groups before and after the use of the syndrome, as well as the differences in the implementation rate of review indicators, evidence-based ability and knowledge and practice of skin toxicity care before and after the use of the syndrome. Results: The incidence and severity of cutaneous toxicity were significantly lower after treatment than before treatment (P P < 0.05). Conclusion: The implementation of immune checkpoint inhibitor-related skin toxicity management procedures can effectively reduce the incidence and severity of skin toxicity symptoms, optimize the clinical pathway, and improve the quality of care.

AI-Driven Learning Management Systems:Modern Developments, Challenges and Future Trends during theAge of ChatGPT

COVID-19 pandemic restrictions limited all social activities to curtail the spread of the virus.The foremost and most prime sector among those affected were schools,colleges,and universities.The education system of entire nations had shifted to online education during this time.Many shortcomings of Learning Management Systems(LMSs)were detected to support education in an online mode that spawned the research in Artificial Intelligence(AI)based tools that are being developed by the research community to improve the effectiveness of LMSs.This paper presents a detailed survey of the different enhancements to LMSs,which are led by key advances in the area of AI to enhance the real-time and non-real-time user experience.The AI-based enhancements proposed to the LMSs start from the Application layer and Presentation layer in the form of flipped classroom models for the efficient learning environment and appropriately designed UI/UX for efficient utilization of LMS utilities and resources,including AI-based chatbots.Session layer enhancements are also required,such as AI-based online proctoring and user authentication using Biometrics.These extend to the Transport layer to support real-time and rate adaptive encrypted video transmission for user security/privacy and satisfactory working of AI-algorithms.It also needs the support of the Networking layer for IP-based geolocation features,the Virtual Private Network(VPN)feature,and the support of Software-Defined Networks(SDN)for optimum Quality of Service(QoS).Finally,in addition to these,non-real-time user experience is enhanced by other AI-based enhancements such as Plagiarism detection algorithms and Data Analytics.

Variable and Invariable,Explore the Value-Creation Techniques of Management Accounting by Benchmarking the Financial Management of Large Enterprises

With the development of information technology such as ChatGPT,artificial intelligence,5G,and so on,technological innovation brings about a qualitative change in the economic business.This change is embodied in breakthroughs in the field of science and technology and the iterative upgrading process of products.The traditional business model undoubtedly fails to adapt to the management needs of modern enterprises,while traditional financial practices and knowledge reserves cannot meet these needs.Faced with sudden technological changes and the emergence of financial sharing,financial robots,etc.,there is an urgent need for financial practitioners to transform from traditional financial accounting to value-creating management accounting.In the future,financial professionals with the ability to embrace uncertainty,adapt to environmental changes,and find breakthroughs in uncertain environments will be the most sought-after by enterprises.This paper aims to benchmark the excellent financial management models of large enterprises and conduct thematic research on financial management in large enterprises.It seeks to explore,in the era of big data management accounting,the road and art of creating value in enterprises.The objective is to provide references for colleagues in the financial field and to explore effective ways to generate value for enterprise management ideas,thus serving as a reference point in the financial transformation journey.

Cost Control Strategies in the Pre-Construction Period of Highway Construction

Effective cost control in the investment and design phases of highway construction is crucial for managing project expenses.However,current management practices often overlook pre-construction cost management,leading to budget overruns and project delays during later stages.To ensure the smooth execution and cost control of highway construction projects,this paper examines the significance of cost control,evaluates the current state and challenges of highway construction,and proposes strategies for cost management.These strategies aim to establish a robust foundation for cost management in highway projects.

Cost Management and Cost Control of Photovoltaic Projects

With the rapid development of the photovoltaic(PV)industry and policy support,photovoltaic engineering has attracted much attention as a clean energy project.However,the complexity and huge investment scale of photovoltaic projects make cost management and cost control the key to project success.The purpose of this paper is to discuss the cost management and cost control strategies of photovoltaic projects,analyze their importance and challenges in the process of project implementation,and discuss the common cost control methods and techniques in photovoltaic projects,to improve cost management and cost control in photovoltaic projects,and to provide a reference for the sustainable development of the industry.

Research on Intelligent Cost Estimation of Engineering Foundation Projects Based on CSIs Theory

Against the backdrop of rapid development in China’s construction and infrastructure sectors,discrepancies between project budgets and actual costs have become pronounced,manifesting in project overruns and suspensions,posing significant challenges.To address inaccuracies in investment targets and operational complexities,this study focuses on a beam-bridge construction project in a district of Shijiazhuang city as a case study.Drawing upon historical analogs,the project employs a Work Breakdown Structure(WBS)to decompose the engineering works.Building on theories of Cost Significant(CS)and Whole Life Costing(WLC),the study constructs Cost Significant Items(CSIs)and develops a CNN-BiLSTM-Attention neural network for nonlinear prediction.By identifying significant cost drivers in engineering projects,this paper presents a streamlined cost estimation method that significantly reduces computational burdens,simplifies data collection processes,and optimizes data analysis and forecasting,thereby enhancing prediction accuracy.Finally,validation with real-world cost fluctuation data demonstrates minor errors,meeting predictive requirements across project execution phases.

Application Analysis of BIM Technology in Construction Engineering Cost Management

With the rapid development of information technology,Building Information Modeling(BIM)technology has gradually occupied an important position in the construction industry.With the introduction of BIM technology,the cost control of construction projects can be greatly improved[1].The use of this technology can not only reduce the project approval time but also improve the quality of the project.In addition,it can also help the construction personnel to solve the project changes,maintenance costs,insurance rates,and other related issues,so that the operation of the project is more efficient and economical.This paper will discuss the role of BIM technology in depth,and explore the advantages and disadvantages of each link through the research of the project,to provide a reference for the promotion of this new project.By constantly adjusting the application strategy,the goal is to meet the current market demand.

Analytic Hierarchy Process for Technological Risks in the Process of Innovative Drug Development in China

Objective To identify the critical risks in the process of innovative drug research and development,and to provide reference for improving the efficiency of innovative drug development and risk control in China.Methods Expert investigation and analytic hierarchy process were used to determine the weights of different risks.Results and Conclusion The research and analysis results showed that the risks at different stages of development had different effects on the success rate of drug development,among which the risk at the drug discovery stage influenced the most.In the drug discovery stage,inappropriate target selection had the greatest impact on the success rate of drug development.The lack of appropriate cell tissue or animal models had the greatest impact on the success rate of drug development from the discovery of a compound to the application for clinical trials.The difference in changes between nonclinical and clinical studies had the greatest impact on the success rate of drug development from early clinical studies to pivotal clinical studies.Incorrect dose selection had the greatest impact on the success rate of drug development from pivotal clinical studies to marketing authorization applications.The biggest impact from the marketing authorization application to the approval stage was inadequate communication with regulators.After investigating the weight of risk factors in the process of innovative drug development based on scientific methods,a new perspective for the risk control of new drug development and improving the research and development efficiency is provided.

Digital Twin-based Quality Management Method for the Assembly Process of Aerospace Products with the Grey-Markov Model and Apriori Algorithm

The assembly process of aerospace products such as satellites and rockets has the characteristics of single-or small-batch production,a long development period,high reliability,and frequent disturbances.How to predict and avoid quality abnormalities,quickly locate their causes,and improve product assembly quality and efficiency are urgent engineering issues.As the core technology to realize the integration of virtual and physical space,digital twin(DT)technology can make full use of the low cost,high efficiency,and predictable advantages of digital space to provide a feasible solution to such problems.Hence,a quality management method for the assembly process of aerospace products based on DT is proposed.Given that traditional quality control methods for the assembly process of aerospace products are mostly post-inspection,the Grey-Markov model and T-K control chart are used with a small sample of assembly quality data to predict the value of quality data and the status of an assembly system.The Apriori algorithm is applied to mine the strong association rules related to quality data anomalies and uncontrolled assembly systems so as to solve the issue that the causes of abnormal quality are complicated and difficult to trace.The implementation of the proposed approach is described,taking the collected centroid data of an aerospace product’s cabin,one of the key quality data in the assembly process of aerospace products,as an example.A DT-based quality management system for the assembly process of aerospace products is developed,which can effectively improve the efficiency of quality management for the assembly process of aerospace products and reduce quality abnormalities.

The Effect of Executive Management Support and Cost Accountant Competency on CMS Design Effectiveness and Its Consequences： An Empirical Research of Manufacturing Business in Thailand＊

The objective of this research is to examine the antecedents and consequences of cost management systems （CMS） design effectiveness of manufacturing businesses in Thailand. The effect of CMS design effectiveness on cost information quality is investigated. Moreover, the effect of cost information quality on business success is investigated. Furthermore, executive management support and cost accountant competency are assumed to become the antecedents of CMS design effectiveness. Electronics manufacturing businesses in Thailand are samples of the research. A mail survey procedure via the questionnaire was used for data collection from accounting controllers. The results indicate that CMS design effectiveness has a positive significant effect on cost information quality. Moreover, cost information quality also has a positive significant effect on business success. Additionally, both executive management support and cost accountant competency have a positive significant effect on CMS design effectiveness.

Integrating Activity-Based Costing （ABC） and Theory of Constraint （TOC） for Improved and Sustained Cost Management

Implementing effective cost management approaches has recently gained momentum due to intense competition and increasing customer demands. Moreover, effective cost management approaches have contributed to firms＇ competitive advantage in relation to cost leadership strategy. Consequently, firms have implemented contemporary cost management systems, such as activity-based management, business process re-engineering, life-cycle costing, target costing, and theory of constraint （TOC）, to enable them to become low-cost producers and compete effectively and sustain their performance. Furthermore, focusing on cost management to improve profitability has led to the integration of activity-based costing （ABC） and TOC. Therefore, the aim of this study is to review literature and discuss how integration of ABC and TOC can result in improved and sustained cost management. While these methods have different approaches in addressing cost management, treating them as complementary cost management approaches can result in improved cost management due to improved product costing, improved cost reporting, improved product-mix decisions, and improved cycle-time management. Improvement in cost management will then result in sustained cost management. Sustained cost management is further enhanced with the investment in information customer and shareholder value technology that supports cross-functional decision making to continue creating to remain competitive in the market.

Thinking About the Economic Management of Universities Based on Capital and Cost Management Optimization

The economic management of colleges and universities has always been a topic of great concern to China’s educational career,therefore,this paper will firstly make the necessary analysis of the current implementation of the economic management of colleges and universities in China,and then the reasons for the problems of economic management of colleges and universities in China is realized a detailed investigation,and finally,the economic management of colleges and universities based on capital and cost management optimization strategy is made a full discussion,looking forward to providing the necessary guidance for researchers in this field.

Time consumption, productivity, and cost analysis of the motor manual tree felling and processing in the Hyrcanian Forest in Iran

An empirical time study was cohducted to evaluate the performance of the current felling and tree processing methods used in Northern Iran＇s Hyrcanian forest. Motor-manual felling is done mostly in winter, while tree processing starts when the felling season ends. We identified the elements of felling and processing work phases, and 142 cycles and 110 cycles were respectively recorded for felling and processing. On the basis of data analysis （time study）, we developed statistical models of effective time consumption in the respective work phase and for its total productivity. The production rate of felling with and without delay time was 9.7 and 11.65 trees per hour （0.17 USD.m^-3 and 0.21 USD-m^-3）, and the average production cost with and without delay was 1.21 USD and 1.45 USD per tree, respectively. The average productivity of processing was 35 m^3 per effective hour and the average unit cost of processing was 0.92 USD.m^-3.