Cost Impact of Increasing Heavy Vehicle Loads on Bridges

This study aimed to investigate the cost impact of meeting the increase in freight demand by doubling the truck weight （AS 1 ）, doubling the traffic volume （AS2）, or legalizing a new-proposed-truck of 97-kip weight instead of the currently legal 80-kip truck （AS3）. The State of Michigan＇s average daily traffic database of year 2001 has been used as a case study. The study was applied only on the very common US Bridge with RC （reinforced concrete） deck over steel girder. Sampling criteria also includes the age of the bridges. The study covered the four-cost-impact categories provided by the NCHRP （National Cooperative Research Program）. The current truck weight and double traffic volume （AS2） show the best scenario to meet the increase in freight demand. However, doubling the truck weight with the current traffic volume （AS 1） was the worst scenario. The use of the proposed 97-kip truck with the current traffic volume （AS3） compromises both, meeting the increase in freight demand and the cost impact.

Cost Optimisation for Minimizing the Visual Impact of Ornamental Stone Quarrying. A Case Study in Murcia Region

Quarrying of ornamental stone has adverse effects that are both visual and environmental. This paper aims to develop a methodology for minimising the costs associated with reducing the visual impact of ornamental stone quarrying. This study uses digital topographical maps of the study zone and a GPS and GIS application to calculate the extent of the area affected by quarrying activities for each altitude designated in the work plan and to calculate the extent of the potential visual impact. The results obtained applying the proposed methodology for the selected area suggested that the potential visual impact is minimal for an altitude of 520 metres, this being the optimal point for the observer. When altitude increases, the potential visual impact increases and the optimal point for the observer diminishes until the highest impact altitude (740 m) is readied. The optimal point that the exploitation should reach is that at which the values of the diagram generated by the (%) area of potential visual impact and area of exploitation (%) intersect. The methodology allows the optimal altitude to be determined for mining exploitations and helps assess the viability of a given exploitation from an environmental point of view.

Economic and Psychosocial Impacts of Health Evacuations Abroad for Coronary Angioplasty in Togolese Patients

Introduction: Coronary artery disease is the leading cause of premature death worldwide. The management of its severe form requires angioplasty, not yet available a year ago in Togo, which motivated the evacuation of Togolese patients with this disease. Objectives: To evaluate the cost of angioplasty and the economic and psychosocial impacts in evacuated Togolese patients. Methodology: This was a three-year descriptive and prospective study (January 2015 to December 2018) that included all Togolese patients evacuated for coronary angiography from 4 health facilities in the city of Lomé. Results: The mean age was 56.8 ± 11 years. There was a male predominance with a sex ratio of 2.63. The main countries of evacuation were France (50%), Tunisia (25%) and Ivory Coast (20%). The main indications of coronary angiography were myocardial infarction in 47.5%, NSTEMI (22.5%) and ischemic heart disease (15%). Fifty-five percent of the patients had monotroncular involvement. Angioplasty was performed in 16 patients, 3 patients had bypass surgery and only one patient had medical treatment. Sixty percent of patients received an active stent and 20% a bare stent. The total cost of the 40 evacuations was four hundred and fifty one thousand four hundred and nineteen US dollars (US$451,419). The average cost per evacuation was eleven thousand two hundred and eighty-six US dollars (US$11,286), or 182 times the Togolese minimum wage. At the announcement of the disease and evacuation, 40% had been afraid and 35% had accepted their illness. Fifty-five percent perceived evacuation as a healthy outcome. In 25% of cases the coronary angiography was simple and 20% found it painful. After the coronary angiography 40% had regained hope of recovery, 37.5% had accepted their result and 37.5% were happy with the outcome. Conclusion: Coronary artery disease is a serious pathology in terms of cardiovascular morbidity and mortality, especially its severe form, which is myocardial infarction, the treatment of which requires angioplasty. This comes back during an evacuation that is too expensive for the average Togolese;only its implementation in our country remains the solution to fight against its often fatal complications as well as the flight of capital and the stress of patients and their families.

Clinical and economic impact of infliximab one-hour infusion protocol in patients with inflammatory bowel diseases:A multicenter study

AIM To assess the impact of short infliximab(IFX) infusion on hospital resource utilization and costs.METHODS All inflammatory bowel diseases(IBD) patients who received IFX 1 h infusion from March 2007 to September 2014 in eight centers from Southern Italy were included in the analysis. Demographic, clinical and infusion related data were collected. The potential benefits related to the short infusion protocol were assessed both in terms of time saving and increased infusion unit capacity. In addition, indirect patient-related cost savings were evaluated.RESULTS One hundred and twenty-five patients were recruited(64 with ulcerative colitis and 61 with Crohn's disease). Median duration of disease was of 53 mo and mean age of pts at diagnosis was of 34 years(SD: ± 13). Adverse infusion reactions were reported in less than 4% both before and after short infusion. The total number of infusions across the selected centers was of 2501(30.5% short infusions). In the analyzed cohort, 1143 h were saved(762 in the infusion and 381 in observation phases) through the rapid IFX infusion protocol. This time saving(-15% compared to the standard protocol in infusion phase) represents, from the hospital perspective, an opportunity to optimize infusion unit capacity by allocating the saved time in alternative cost-effective treatments. This is the case of opportunity cost that represents the value of forgone benefit which could be obtained from a resource in its next-best alternative use. Hence, an extra hour of infusion in the case of standard 2-h IFX represents a loss in opportunity to provide other cost effective services. The analysis showed that the short infusion increased the infusion units capacity up to 50% on days when the IFX infusions were scheduled(infusion phase). Furthermore, the analysis showed that the short IFX infusion protocol leads to time savings also in the post-infusion phase(observation) leading to a time saving of 10% on average among the analyzed centers. Finally, the short infusion protocol has been demonstrated to lead to indirect cost savings of €138/patient(average-€17.300 on the whole cohort).CONCLUSION A short IFX infusion protocol can be considered time and cost saving in comparison to the standard infusion protocol both from the hospital's perspective, as it contributes to increase infusion units capacity, and the patients' perspective, as it reduces indirect costs and the impact of treatment on everyday life and work productivity.

The Economic Impact of Artificial Intelligence on Healthcare: A Literature Review

Background: This review delves into the effects of artificial intelligence (AI) on healthcare, which is a crucial aspect considering the increasing costs of healthcare worldwide. While there is potential for AI to enhance healthcare delivery and efficiency, there are still uncertainties surrounding its effectiveness, value, and broader adoption. This comprehensive literature review aims to explore and synthesize existing knowledge on the economic impact of AI in healthcare. The primary objective of this review is to understand the potential cost savings and efficiency improvements associated with the deployment of AI in healthcare settings. By highlighting the economic implications of AI, this review seeks to offer insights into the value proposition of investing in AI technologies for stakeholders such as healthcare providers, payers, and policymakers. Methods: To conduct this review, we conducted a search of literature from 2020 to 2023 across three databases: PubMed, Scopus and Google Scholar. We specifically focused on studies that discuss the impacts of AI in healthcare and include cost evaluations, using combinations of keywords related to AI, economics, healthcare, and cost evaluation. The inclusion criteria were studies that conducted some form of economic evaluation related to AI in healthcare settings, while exclusion criteria were studies without a cost evaluation component. Data extraction and quality assessment using the CASP checklist were undertaken on the final set of included studies. Results: After screening studies, we identified 10 out of a total of 28 studies and reports that met our criteria of outlining any form of economic impact and evaluation of AI in healthcare settings. Based on our findings, implementing AI in healthcare could potentially lead to cost savings. Several studies suggest savings ranging from $200 billion to $360 billion in the United States alone. The use of AI in healthcare sectors such as ophthalmology, radiology and disease screening has shown positive economic impacts. Conclusion: While AI has potential for cost savings and efficiency improvements, in healthcare settings, it’s crucial to conduct detailed context specific cost evaluations to optimize the adoption and implementation strategies of AI.

Mitigating the Environmental Effects of Oil and Gas Exploitation: Issues of Compliance, Cost of Production, and Community Awareness

This study assessed the effectiveness of mitigation measures adopted to address the environmental effects of oil and gas industries from the perspective of compliance, cost of production, and community awareness. The research applied a case study through multi-method-qualitative and quantitative approaches. The target population of 547,368 people involved people in Takoradi, Shama and Newtown communities. A sample size of 150 was selected and categorised under 36% for Shama, 30% for Newtown and 34% for Takoradi. A combination of probability (simple random) and non-probability (cluster and convenience) sampling frames were used to access the respondents for the study. Data collection tools were limited to questionnaires and interview sessions. The descriptive statistics, Relative Importance Index (RII) and significance testing using a one-sample t-test module guided the analysis. Interview sessions were compiled into transcripts and later categorized into themes that directly reflected the patterns of the questions on the questionnaire. The conclusion rated major decisions in mitigating oil and gas impacts on the environment as first for conscious effort to package fuel and other chemicals in safe storages, followed by the use of best road systems to reduce the risk of accidents, then application of strict rules and regulations to curb impacts and lastly capacity building for participants in the oil and gas production industry. While significant measures have been adopted to mitigate the effects of oil and gas exploration, there remain challenges with effectiveness as a result of weakness in community involvement efforts, lack of motivation, weak laws and regulations and loss of respect. For effectiveness in reducing the challenges to mitigate the environmental impacts of the oil and gas production activity, policymakers, as well as the practitioners in the oil production industry, are advised to motivate people into buying into their policy to reduce such impacts.

Cost Utility Analysis of Dapagliflozin in Egyptian Patients with CKD from the Payer Perspective

Background: Chronic kidney disease is a serious public health issue in Egypt. An estimated 13% of individuals in Egypt are expected to have CKD, with a higher prevalence among older adults and in rural regions. The primary goal of the study was to compare the cost-utility of the standard of care alone against add-on medication, dapagliflozin, as a preventative measure against complications of CKD in cases with or without diabetes mellitus. Methods: A lifetime Markov state transition model with a 3-month cycle was employed based on the clinical evidence from the DAPA-CKD clinical trial. The model was to provide estimates of the long-term economic and health impact of managing CKD patients. Cost-effectiveness is assessed regarding the cost per quality-adjusted life year (QALY) gained. This economic evaluation study used a payer perspective. Moreover, the study evaluated the impact on the budget due to the undertaking of dapagliflozin. One-way deterministic sensitivity analyses, as well as a probabilistic sensitivity analysis, were employed. Results: During a lifetime horizon, the difference in cost between dapagliflozin and SOC was EGP -65,212 (USD 2126.89). The difference in QALY between dapagliflozin and SOC was 4.3. In CKD patients, adding dapagliflozin to ramipril generates better QALYs and lower costs than ramipril alone. Dapagliflozin improved the outcomes and generated cost savings. A deterministic one was sensitivity analysis revealed that the model is robust to changes in all variables included. Probabilistic sensitivity analysis using Monte Carlo simulation with 10,000 iterations showed that in about 82.64% of trials, dapagliflozin is cost-saving. The undertaking of dapagliflozin by any percent will have a positive impact on the budget. Conclusion: During the lifetime horizon, dapagliflozin is cost-saving;it benefits the quality of life and the total cost. The addition of dapagliflozin to SOC has a saving effect of 11.9% of the budget.

我国中老年人助听器康复干预的经济学评价研究

目的:对助听器康复干预进行成本效果分析,并考虑将助听器纳入医疗保险后对医保预算的影响。方法:利用在山东省临沂市开展的助听器康复干预的随机对照试验,通过双重差分法进行增量成本效果分析,以年人均国内生产总值作为是否具有成本效果的阈值;其次进行预算影响分析,测算在不同助听器报销比例下的医保预算费用变动。结果:假设每副助听器的购买费用为10,000元,助听器的平均使用年限为n年,若n>2.20,则干预非常具有成本效果;若1.88<n<2.20,则干预增加的成本效果可以接受;若n<1.88,则干预措施不具有成本效果。若将助听器购买费用纳入医疗保险系统,最多约需3.25年医保预算即可持平。结论:助听器干预是一种具有成本效果的听力康复手段,且若将其纳入医保报销,长期来看可节约医保预算。因此,本研究建议完善与听力障碍康复相关的保障政策,如鼓励助听器技术的研发和创新、推动将助听器纳入医保报销等,从而促进听力治疗和康复干预。

基于AHP的绿色住宅全寿命周期成本影响因素研究

基于全寿命周期视角构建了绿色住宅全寿命周期成本影响因素体系,通过层次分析法构建绿色住宅全寿命周期成本影响因素层次结构模型,并对影响因素进行权重赋值。研究表明,绿色技术水平、绿色性能、废弃物循环利用技术分别为影响绿色住宅全寿命周期成本3个阶段的最为关键的影响因素,并提出了相应的对策和建议,为绿色住宅全寿命周期成本的有效控制提供理论借鉴和实际价值。

数字化转型、债务融资成本对企业绩效的影响研究

数字化时代背景下,数字化转型已成为企业发展的重要趋势。文章基于2010—2021年A股上市公司的数据,探讨了企业数字化转型对其绩效的影响。研究发现:数字化转型对企业绩效产生短期负向但长期正向的影响;数字化转型可以通过降低债务融资成本来提升企业绩效;异质性检验发现,高新技术行业的数字化转型不会对企业绩效产生负向影响。基于上述研究结论,文章分别从政府、企业两个层面提出了进一步推动中国企业数字化转型的若干具体对策建议。

基于InfoWorks ICM模型的城市小区LID组合方案成本效益研究

针对低影响开发(LID)雨水系统建设中存在成本与效益难以平衡的问题,选取甘肃省天水市某居住小区为研究对象,构建InfoWorks ICM一、二维耦合模型,以不同LID组合方案在不同降雨重现期下的径流总量控制率、径流峰值削减率、积水面积削减率、积水量削减率、固体悬浮物(SS)削减率、化学需氧量(COD)削减率为效益表征量,结合LID设施的生命周期成本定量分析成本效益。结果表明:包含绿色屋顶的LID组合方案成本效益偏低,但对于高重现期降雨具有较强的适应能力,更适用于暴雨频发地区;LID组合方案对于积水面积削减率与积水量削减率的成本效益较高,能有效缓解内涝积水,对于COD削减率的成本效益较低,需进一步优化;雨水桶+生物滞留设施+透水铺装作为总成本效益最高的方案,更适用于研究区域LID雨水系统的建设。研究成果对LID雨水系统的优化设计具有重要参考意义。

湖北省典型农村生活污水处理技术比选

农村生活污水治理是攻坚战的一项重要任务。由于湖北省地形复杂、河流众多、农村人口居住分散,农村污水治理存在很多困难和问题,亟需探索适合的实用处理工艺和技术模式。该文利用SimaPro 9.0软件,对湖北省4种典型农村生活污水处理技术——人工湿地、厌氧-好氧工艺、膜生物反应器和生物接触氧化法(BCO)建立生命周期评价模型,对比各系统全生命周期内的环境影响,并结合成本分析为农村生活污水处理技术的择选提供决策依据。结果表明:呼吸无机物是最主要的环境影响类型,与原材料生产、运输过程涉及大量化石能源的使用有关;各系统的环境影响主要来自建设阶段(99%),经济成本主要来自运行阶段(80%);BCO是4种典型技术中低环境影响、低成本的最佳方案。基于评价结果,可通过清洁生产、降低能耗等措施改善处理技术对环境和经济的负面影响,促进农村水环境的可持续发展。

现代信息化技术对建筑工程造价控制的影响

针对传统建筑工程造价控制中存在的效率低和精确性不足等问题,论文分析了现代信息化技术在建筑工程造价控制管理中的应用。通过分析信息化技术的具体应用策略,特别是建筑信息模型与大数据分析等技术在造价控制中的应用,深入探讨了如何应用这些技术优化成本预测并强化造价管理的决策支持。

建筑工程预算编制对工程造价的影响

在建筑工程的规划与实施中,工程造价的控制与管理起着至关重要的作用。它不仅关乎项目的经济效益,也直接影响到工程的质量与进度。而建筑工程预算编制,作为工程造价管理的核心环节,其科学性、准确性和全面性将直接决定工程造价的预估结果,从而对工程的决策制定、成本控制及风险防范产生深远影响。

建筑工程施工进度管理对工程造价的影响分析

建筑工程施工进度管理是确保项目按预定计划顺利完成的关键因素,其不仅直接影响工程质量和施工安全,还对工程造价的控制起着至关重要的作用。文章从建筑工程施工进度管理的概念与重要性、影响建筑工程施工进度管理的主要因素、建筑工程施工进度管理对工程造价的影响、建筑工程施工进度管理关键技术与模式探究、典型案例等方面进行了论述,旨在通过分析建筑工程施工过程中进度管理的重要性以及其对工程造价的影响,减少浪费并提升资源利用效率。

建筑工程变更管理对工程造价的影响与应对措施

文章旨在探索建筑工程变更管理对施工成本的冲击,以及相应的策略调整。通过分析和研究诸多实际案例,发现变更管理不仅对项目成本和进度产生直接影响,也在特定层面成为优化项目效益的转机点。科学地执行改动管理有助于遏制项目预算膨胀,并在保障质量稳固的前提下提升运作效率。改动管理对项目进展带来双向影响,可能引发延误,还可能推动施工进度向前。文章的核心目标在于构建针对性的解决模版以面对因建设业工程变更所引起的各项挑战。

项目管理中风险评估对工程造价的影响

在工程项目管理中,风险评估扮演着举足轻重的角色,是一个至关重要的环节。它作为结构化的过程,不仅直接关系到项目的顺利进行,更是影响工程造价的关键因素。通过深入剖析项目风险,在识别、分析以及评估三个阶段,我们可以更准确地预测和评估其对工程造价的潜在影响。为预防潜在风险,提高决策质量,保护项目利益,降低工程造价风险,提高项目效益,我们需要制定有效的应对策略,包括但不限于建立完善的风险评估体系、加强风险沟通与协作、针对风险制定相应的应对措施、优化项目管理流程、加强风险预警机制、提升团队风险应对能力等。通过这些措施,我们旨在确保项目在可控的范围内顺利推进,从而实现工程造价的最优化,提高项目的整体效益和竞争力。

概预算编制质量对建筑工程造价的影响分析

为保证建筑工程的稳定发展,施工单位需要重视概预算的编制质量。基于此,文章全面分析了概预算编制质量对建筑工程造价的影响,提出了强化建筑工程概预算编制质量的相关措施,以供参考。

建筑工程中的施工工程变更管理与造价影响分析

建筑工程中的工程变更管理是确保项目成功完成的关键要素之一。文章探讨了建筑工程中的工程变更管理的重要性,以及分析了如何应对工程变更对造价的影响。通过明确的变更管理流程、明确的审批和执行程序、信息技术的应用以及风险管理的整合,可以有效应对工程变更带来的挑战,并最大程度地降低造价。文章旨在为建筑工程领域的从业者、项目管理者和决策者提供关于工程变更管理的深入理解和有用信息。

“双碳”目标下征收碳税对汽车制造业的成本影响

征收碳税对汽车制造业的成本产生深远影响,不仅涉及生产成本的增加,还涉及企业战略调整、技术创新、市场竞争等多个方面。探讨双碳目标下征收碳税对汽车制造业成本的影响,旨在为政策制定和企业决策提供有益参考。