The use of anti-tumor necrosis factor-α therapy for inflammatory bowel disease represents the most important advance in the care of these patients since the publication of the National Co-operative Crohn＇s disease s...The use of anti-tumor necrosis factor-α therapy for inflammatory bowel disease represents the most important advance in the care of these patients since the publication of the National Co-operative Crohn＇s disease study thirty years ago. The recommendations of numerous consensus groups worldwide are now supported by a wealth of clinical trials and several meta-analyses. In general, it is suggested that tumor necrosis factor-c~ blockers （TNFBs） are indicated （1） for persons with moderately-severe Crohn＇s disease or ulcerative colitis （UC） who have failed two or more causes of glucocorticosteroids and an acceptably long cause （8 wk to 12 wk） of an immune modulator such as azathioprine or methotrexate; （2） non-responsive perianal disease; and （3） severe UC not responding to a 3-d to 5-d course of steroids. Once TNFBs have been introduced and the patient is responsive, therapy given by the IV and SC rate must be continued. It remains open to definitive evidence if concomitant immune modulators are required with TNFB maintenance ther- apy, and when or if TNFB may be weaned and discon- tinued. The supportive evidence from a single study on the role of early versus later introduction of TNFB in the course of a patient＇s illness needs to be confirmed. The risk/benefit profile of TNFB appears to be accept- able as long as the patient is immunized and tested for tuberculosis and viral hepatitis before the initiation of TNFB, and as long as the long-term adverse effects on the development of lymphoma and other tumors do not prone to be problematic. Because the rates of ben- efits to TNFB are modest from a population perspec- tive and the cost of therapy is very high, the ultimate application of use of TNFBs will likely be established by cost/benefit studies.展开更多
There is a need for cost-efficient methods in consumer research. Existing qualitative methods are expensive to conduct. This paper aims to improve the focus group method. The objective was to improve focus groups with...There is a need for cost-efficient methods in consumer research. Existing qualitative methods are expensive to conduct. This paper aims to improve the focus group method. The objective was to improve focus groups with different aims： shorter time conducting interviews, interview greater number of respondents, deliver results faster than traditionally analysis of data, and lower total cost. CurroCus groups of 15-45 minutes duration were tested in five different experiments, including 70 to 160 respondents in groups of 7-11 respondents. The name of the new method is formed from the word ＂Curro＂ in Latin that means speed in English, and ＂Cus＂ that is the last syllable of the word ＂focus＂, thereby forming a new word： CurroCus~ on the method. The results from testing of the CurroCus~ group method at different cases showed that trained moderators and observers could collect relevant responses in a given time for each group. It was possible to process a number of 6 to 10 respondents for each group. By conducting several successive groups, saturation of information was reached after an adequate number of CurroCus~ groups. Therefore, the total number of respondents can be optimized and results can be more precise, with reduced risk of inaccuracy. At the same time, the cost for each case can be lowered substantially, in our cases to approximately 1/10 of a traditional focus group cost. The role （skills） of the moderator is important. A disadvantage is the risk that some of the respondents are not able to express their thoughts in due time when time is limited. There is a need for more research on all parts of the CurroCus group process.展开更多
The Magnetic Barkhausen Noise （MBN） technology is a non-destructive method to measure the neutral temperature of thc CWR track. A series of in-field verifications and data comparison on Australian mainline tracks ha...The Magnetic Barkhausen Noise （MBN） technology is a non-destructive method to measure the neutral temperature of thc CWR track. A series of in-field verifications and data comparison on Australian mainline tracks have shown the results from that system are highly accurate and reliable. The system can be an accuracy and cost-effective tool to prevent the potential buckling and break of CWR rails. The physical backgrounds and features of the system are represented in this paper. The Darwin-Alice Springs Line is a newly constructed main line in Australia which is linked from the north and middle of Australia. Originally, this rail line is designed and constructed in a ＂cost-effective＂ way to a lower price, and the key parameters are relatively low. To maintain the stability of the CWR tracks in a very harsh environment, some new technologies such as the MBN technology were utilised. From the results of neutral temperature, it is found that the majority of them are very high. Combined with the calculation and finite element analysis, these problems evidenced that it is caused by the low toe load fastening system and high sleeper spacing. After that some suggestions are given to improve the stability of the CWR on the railway line.展开更多
The quality standard ISO 9001 helps and enables organizations, regardless of the sector where they exist, to implement the quality management properly. Recent years have attracted attention to the possibilities of imp...The quality standard ISO 9001 helps and enables organizations, regardless of the sector where they exist, to implement the quality management properly. Recent years have attracted attention to the possibilities of implementing this standard in the health sector and the economic viability of that long-term investment. Health care organizations are recognizing the value system that combines all the criteria for managing quality, including management of business, compliance and management of procedural steps, and most importantly, the total quality management. In general, the implementation of ISO 9001：2008 standard for quality in health care institutions is seen as an opportunity to improve the quality of health care, and the entire process is to be completed by reducing costs and improving services in the sector. The implementation of a quality standard is directed towards patients, medical staff, and management in order to achieve reduction and complete relief from the pain, correct and professional services, conducted services with an appropriate skilled and professional care to obtain results that are comparable to known standards, and protection services with appropriate insurance policies, and the management expects the implementation of a quality system to justify and return their investments. The methods used in this paper are based on the quality standard ISO 9001：2008--Quality Management System and the Guidelines for Improving Performance, developed based on ISO 9004：2000： Quality Management System-43uidelines for Continuous Improvement. These guidelines contain a big part of the text in ISO 9004：2000, but they are supplemented with specific guidelines for their implementation in the health sector. The implementation of the system and monitoring guidelines evidently contributes to the overall resolution and closure of problems in over 50% of cases. This not only results in saving money for the institution, but it also globally leads to reduced variations in the healing process. Expected benefits from implementing the system in the health care sector in the Republic of Macedonia relate to providing a substantial foundation for obtaining all the necessary facilities and reduction of the costs by reducing the inappropriate staff in exactly determined departments. Implementation of future accreditation processes can be accomplished in a much shorter period of time, especially when there is good communication and cooperation among the departments. Improved working systems, processes, and final results inevitably contribute to happy and healthy patients.展开更多
We read with great interest the editorial article by Meshikhes AWN published in issue 25 of World J Gastroenterol 2011.The article described the advantages of emergency laparoscopic appendectomy compared with interval...We read with great interest the editorial article by Meshikhes AWN published in issue 25 of World J Gastroenterol 2011.The article described the advantages of emergency laparoscopic appendectomy compared with interval appendectomy as a new safe treatment modality for the appendiceal mass.The author concluded that the emergency laparoscopic appendectomy was a safe treatment modality for the appendiceal mass,and might prove to be more cost-effective than conservative treatment,with no need for interval appendectomy.However,we would like to highlight certain issues regarding the possibility of percutaneous catheter drainage to successfully treat the appendiceal mass,with no need for appendectomy,too.展开更多
Companies are currently immersed in a process of competitiveness, which is increasingly more complicated to achieve differentiation that can guarantee you the preference of customers and consequently the success of th...Companies are currently immersed in a process of competitiveness, which is increasingly more complicated to achieve differentiation that can guarantee you the preference of customers and consequently the success of the organization. It becomes partly crucial for the organization to be in the dynamics of the sector and market where it operates and wants its consolidation, because value systems become strategic elemente that play a role as key factors of success in organizations seeking priority intend to increase their organizational performance. Given the above, this research seeks to get to identify strategic uses of information and communication technologies in the processes of the value chain in small commercial businesses in Mexicali, aiming to contribute to the improvement of the competitiveness of the same. It is in this sense that the technologies of information and communication have become a powerful tool that will allow them to be innovative, cost-effective and this will have an impact on the performance of the organization that will allow you to improve your service, interact with customers and suppliers, and above all more efficiently meet their own needs and organizational expectations. This research was exploratory and within the relevant findings, coming to the conclusion that it is necessary to focus more emphatically on the client; organizations have deficiencies in relation to the strategic use of ICTs to streamline their billing, manufacturing, distribution, and storage of your products, activities highlighting this if they don＇t have a reconsideration in this aspect, at the risk of offset in terms of its competitors which would mean ceasing to be option on the market, stressing that this not only will be a trigger factor in mature companies, but those who need to improve their service and that they will serve as input for the conduction of processes along the value chain. The research is exploratory in nature, as evidenced in the use of the ICTs focused on the man~,gement of the value chain and its relationship with different variables of such management, making that they are discovered behaviors on the structure of the value chain able to generate sustainable benefits and contribute to the improvement of the competitive position of the companies involved in this study.展开更多
Safeguarding plants as seeds in ex situ collections is a cost effective element in an integrated plant conservation approach. The European Alps are a regional centre of plant diversity. Six institutions have establish...Safeguarding plants as seeds in ex situ collections is a cost effective element in an integrated plant conservation approach. The European Alps are a regional centre of plant diversity. Six institutions have established a regional network covering the European Alps which will conserve at least 500 priority plant species and which will improve the conservation status of plant species in grassland communities in the subalpine, alpine and nival altitudinal belts. Targeted research will expand the knowledge of the ecology of target speeies. Public engagement activities will raise the awareness for the importance of specific conservation actions in the European Alps.展开更多
Filgrastim is used to accelerate hematopoietic recovery after ABMT （allogeneic bone marrow transplantation）. Its impact on the total cost of patient care remains to be explored. We therefore undertook a cost effecti...Filgrastim is used to accelerate hematopoietic recovery after ABMT （allogeneic bone marrow transplantation）. Its impact on the total cost of patient care remains to be explored. We therefore undertook a cost effectiveness analysis in the context of a randomized single blinded clinical trial of Filgrastim versus placebo in post ABMT. A primary endpoint, duration of myelosuppression, and three secondary end points （number of days of fever, length of hospital stay, survival at one hundred days） were used to assess efficacy. Direct costs were evaluated and allowed the calculation of the ICER （incremental cost-effectiveness ratios） for the major endpoint of the trial. Sixteen patients were included in the study. The duration of myelosuppression was significantly decreased in the Filgrastim arm with medians of 15 days vs. 19 days in the placebo arm （p = 0.023）. Cost analysis showed no statistically significant difference between the two arms. According to the calculation of ICER, Filgrastim was more costly and more effective than placebo for the number of days of aplasia avoided and the number of days with fever avoided. Placebo strictly dominated filgrastim for days of hospitalization avoided. Filgrastim has proven effective in reducing the duration of aplasia without increasing costs.展开更多
Polygynous males can change their mating tactics across their lifetime, but information is scarce on the flexibility of this trait within a given season and the relative costs and benefits of using different tactics. ...Polygynous males can change their mating tactics across their lifetime, but information is scarce on the flexibility of this trait within a given season and the relative costs and benefits of using different tactics. Here, we monitored individually marked male reindeer Rangifer tarandus and classified their mating tactics as harem-defense, sneaking, or mixed. The costs of the male reproductive effort were assessed using both direct （i.e. percentage of body mass lost） and indirect measures （i.e. activity patterns such as feeding, standing, and walking）, while mating group size and reproductive success were recorded as mating ef- fort benefits. Our results show that reindeer males may switch between the harem-defense and sneaking tactics throughout the same breeding season, providing further support to the notion that reproductive tactics are flexible in ungulates. The costs and benefits of male mating effort vary according to the mating tactic, reaching the highest values in harem-holders and the lowest values in sneaking males. Moreover, males who switched between the sneaking tactic and the harem-defence tactic tended to achieve higher mating success than males who consistently used the least costly tactic. Indeed, all harem-holders successfully sired offspring, whereas only two out of three mixed-tactic males sired one calf, and sneaking males did not sire any calves. In conclusion, our results show that reindeer males can modulate their mating efforts during the same breeding season by switching between the most costly harem-defense tactic and the least costly sneaking tactic, suggesting individual solutions to the balance between reproductive effort and mating opportunities [Current Zoology 61 （5）： 802-810, 2015].展开更多
文摘The use of anti-tumor necrosis factor-α therapy for inflammatory bowel disease represents the most important advance in the care of these patients since the publication of the National Co-operative Crohn＇s disease study thirty years ago. The recommendations of numerous consensus groups worldwide are now supported by a wealth of clinical trials and several meta-analyses. In general, it is suggested that tumor necrosis factor-c~ blockers （TNFBs） are indicated （1） for persons with moderately-severe Crohn＇s disease or ulcerative colitis （UC） who have failed two or more causes of glucocorticosteroids and an acceptably long cause （8 wk to 12 wk） of an immune modulator such as azathioprine or methotrexate; （2） non-responsive perianal disease; and （3） severe UC not responding to a 3-d to 5-d course of steroids. Once TNFBs have been introduced and the patient is responsive, therapy given by the IV and SC rate must be continued. It remains open to definitive evidence if concomitant immune modulators are required with TNFB maintenance ther- apy, and when or if TNFB may be weaned and discon- tinued. The supportive evidence from a single study on the role of early versus later introduction of TNFB in the course of a patient＇s illness needs to be confirmed. The risk/benefit profile of TNFB appears to be accept- able as long as the patient is immunized and tested for tuberculosis and viral hepatitis before the initiation of TNFB, and as long as the long-term adverse effects on the development of lymphoma and other tumors do not prone to be problematic. Because the rates of ben- efits to TNFB are modest from a population perspec- tive and the cost of therapy is very high, the ultimate application of use of TNFBs will likely be established by cost/benefit studies.
文摘There is a need for cost-efficient methods in consumer research. Existing qualitative methods are expensive to conduct. This paper aims to improve the focus group method. The objective was to improve focus groups with different aims： shorter time conducting interviews, interview greater number of respondents, deliver results faster than traditionally analysis of data, and lower total cost. CurroCus groups of 15-45 minutes duration were tested in five different experiments, including 70 to 160 respondents in groups of 7-11 respondents. The name of the new method is formed from the word ＂Curro＂ in Latin that means speed in English, and ＂Cus＂ that is the last syllable of the word ＂focus＂, thereby forming a new word： CurroCus~ on the method. The results from testing of the CurroCus~ group method at different cases showed that trained moderators and observers could collect relevant responses in a given time for each group. It was possible to process a number of 6 to 10 respondents for each group. By conducting several successive groups, saturation of information was reached after an adequate number of CurroCus~ groups. Therefore, the total number of respondents can be optimized and results can be more precise, with reduced risk of inaccuracy. At the same time, the cost for each case can be lowered substantially, in our cases to approximately 1/10 of a traditional focus group cost. The role （skills） of the moderator is important. A disadvantage is the risk that some of the respondents are not able to express their thoughts in due time when time is limited. There is a need for more research on all parts of the CurroCus group process.
文摘The Magnetic Barkhausen Noise （MBN） technology is a non-destructive method to measure the neutral temperature of thc CWR track. A series of in-field verifications and data comparison on Australian mainline tracks have shown the results from that system are highly accurate and reliable. The system can be an accuracy and cost-effective tool to prevent the potential buckling and break of CWR rails. The physical backgrounds and features of the system are represented in this paper. The Darwin-Alice Springs Line is a newly constructed main line in Australia which is linked from the north and middle of Australia. Originally, this rail line is designed and constructed in a ＂cost-effective＂ way to a lower price, and the key parameters are relatively low. To maintain the stability of the CWR tracks in a very harsh environment, some new technologies such as the MBN technology were utilised. From the results of neutral temperature, it is found that the majority of them are very high. Combined with the calculation and finite element analysis, these problems evidenced that it is caused by the low toe load fastening system and high sleeper spacing. After that some suggestions are given to improve the stability of the CWR on the railway line.
文摘The quality standard ISO 9001 helps and enables organizations, regardless of the sector where they exist, to implement the quality management properly. Recent years have attracted attention to the possibilities of implementing this standard in the health sector and the economic viability of that long-term investment. Health care organizations are recognizing the value system that combines all the criteria for managing quality, including management of business, compliance and management of procedural steps, and most importantly, the total quality management. In general, the implementation of ISO 9001：2008 standard for quality in health care institutions is seen as an opportunity to improve the quality of health care, and the entire process is to be completed by reducing costs and improving services in the sector. The implementation of a quality standard is directed towards patients, medical staff, and management in order to achieve reduction and complete relief from the pain, correct and professional services, conducted services with an appropriate skilled and professional care to obtain results that are comparable to known standards, and protection services with appropriate insurance policies, and the management expects the implementation of a quality system to justify and return their investments. The methods used in this paper are based on the quality standard ISO 9001：2008--Quality Management System and the Guidelines for Improving Performance, developed based on ISO 9004：2000： Quality Management System-43uidelines for Continuous Improvement. These guidelines contain a big part of the text in ISO 9004：2000, but they are supplemented with specific guidelines for their implementation in the health sector. The implementation of the system and monitoring guidelines evidently contributes to the overall resolution and closure of problems in over 50% of cases. This not only results in saving money for the institution, but it also globally leads to reduced variations in the healing process. Expected benefits from implementing the system in the health care sector in the Republic of Macedonia relate to providing a substantial foundation for obtaining all the necessary facilities and reduction of the costs by reducing the inappropriate staff in exactly determined departments. Implementation of future accreditation processes can be accomplished in a much shorter period of time, especially when there is good communication and cooperation among the departments. Improved working systems, processes, and final results inevitably contribute to happy and healthy patients.
文摘We read with great interest the editorial article by Meshikhes AWN published in issue 25 of World J Gastroenterol 2011.The article described the advantages of emergency laparoscopic appendectomy compared with interval appendectomy as a new safe treatment modality for the appendiceal mass.The author concluded that the emergency laparoscopic appendectomy was a safe treatment modality for the appendiceal mass,and might prove to be more cost-effective than conservative treatment,with no need for interval appendectomy.However,we would like to highlight certain issues regarding the possibility of percutaneous catheter drainage to successfully treat the appendiceal mass,with no need for appendectomy,too.
文摘Companies are currently immersed in a process of competitiveness, which is increasingly more complicated to achieve differentiation that can guarantee you the preference of customers and consequently the success of the organization. It becomes partly crucial for the organization to be in the dynamics of the sector and market where it operates and wants its consolidation, because value systems become strategic elemente that play a role as key factors of success in organizations seeking priority intend to increase their organizational performance. Given the above, this research seeks to get to identify strategic uses of information and communication technologies in the processes of the value chain in small commercial businesses in Mexicali, aiming to contribute to the improvement of the competitiveness of the same. It is in this sense that the technologies of information and communication have become a powerful tool that will allow them to be innovative, cost-effective and this will have an impact on the performance of the organization that will allow you to improve your service, interact with customers and suppliers, and above all more efficiently meet their own needs and organizational expectations. This research was exploratory and within the relevant findings, coming to the conclusion that it is necessary to focus more emphatically on the client; organizations have deficiencies in relation to the strategic use of ICTs to streamline their billing, manufacturing, distribution, and storage of your products, activities highlighting this if they don＇t have a reconsideration in this aspect, at the risk of offset in terms of its competitors which would mean ceasing to be option on the market, stressing that this not only will be a trigger factor in mature companies, but those who need to improve their service and that they will serve as input for the conduction of processes along the value chain. The research is exploratory in nature, as evidenced in the use of the ICTs focused on the man~,gement of the value chain and its relationship with different variables of such management, making that they are discovered behaviors on the structure of the value chain able to generate sustainable benefits and contribute to the improvement of the competitive position of the companies involved in this study.
基金funding from the David and Claudia Harding Foundation to ensure the survival of endangered plants and habitats in the European Alps
文摘Safeguarding plants as seeds in ex situ collections is a cost effective element in an integrated plant conservation approach. The European Alps are a regional centre of plant diversity. Six institutions have established a regional network covering the European Alps which will conserve at least 500 priority plant species and which will improve the conservation status of plant species in grassland communities in the subalpine, alpine and nival altitudinal belts. Targeted research will expand the knowledge of the ecology of target speeies. Public engagement activities will raise the awareness for the importance of specific conservation actions in the European Alps.
文摘Filgrastim is used to accelerate hematopoietic recovery after ABMT （allogeneic bone marrow transplantation）. Its impact on the total cost of patient care remains to be explored. We therefore undertook a cost effectiveness analysis in the context of a randomized single blinded clinical trial of Filgrastim versus placebo in post ABMT. A primary endpoint, duration of myelosuppression, and three secondary end points （number of days of fever, length of hospital stay, survival at one hundred days） were used to assess efficacy. Direct costs were evaluated and allowed the calculation of the ICER （incremental cost-effectiveness ratios） for the major endpoint of the trial. Sixteen patients were included in the study. The duration of myelosuppression was significantly decreased in the Filgrastim arm with medians of 15 days vs. 19 days in the placebo arm （p = 0.023）. Cost analysis showed no statistically significant difference between the two arms. According to the calculation of ICER, Filgrastim was more costly and more effective than placebo for the number of days of aplasia avoided and the number of days with fever avoided. Placebo strictly dominated filgrastim for days of hospitalization avoided. Filgrastim has proven effective in reducing the duration of aplasia without increasing costs.
文摘Polygynous males can change their mating tactics across their lifetime, but information is scarce on the flexibility of this trait within a given season and the relative costs and benefits of using different tactics. Here, we monitored individually marked male reindeer Rangifer tarandus and classified their mating tactics as harem-defense, sneaking, or mixed. The costs of the male reproductive effort were assessed using both direct （i.e. percentage of body mass lost） and indirect measures （i.e. activity patterns such as feeding, standing, and walking）, while mating group size and reproductive success were recorded as mating ef- fort benefits. Our results show that reindeer males may switch between the harem-defense and sneaking tactics throughout the same breeding season, providing further support to the notion that reproductive tactics are flexible in ungulates. The costs and benefits of male mating effort vary according to the mating tactic, reaching the highest values in harem-holders and the lowest values in sneaking males. Moreover, males who switched between the sneaking tactic and the harem-defence tactic tended to achieve higher mating success than males who consistently used the least costly tactic. Indeed, all harem-holders successfully sired offspring, whereas only two out of three mixed-tactic males sired one calf, and sneaking males did not sire any calves. In conclusion, our results show that reindeer males can modulate their mating efforts during the same breeding season by switching between the most costly harem-defense tactic and the least costly sneaking tactic, suggesting individual solutions to the balance between reproductive effort and mating opportunities [Current Zoology 61 （5）： 802-810, 2015].
