Thesis (S.M.)--Massachusetts Institute of Technology, Engineering Systems Division, Technology and Policy Program, 2003. / Includes bibliographical references. / This electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections. / Despite its development and suitability to many specialties of medicine for the past forty years and the driving demands of an aging population, telemedicine has not made significant progress in deployment or commercialization. Why is this? Three case studies of health networks were used to identify the barriers to the widespread use of telemedicine in home healthcare and other applications of medicine. These barriers were further described and analyzed using the framework for disruptive technologies presented in Clayton Christensen' s The Innovator' s Dilemma. Although many studies assert that the slow adoption rate of telemedicine is explained by questions of efficacy and cost, this analysis proposes that the change in value networks posed by telemedicine technology is the greatest reason for its anemic implementation. Telemedicine changes the structure of the healthcare sector changing the organizational dynamics and values of the many players. The changes in structure are explored using the case studies and the successes and failures experienced by the health networks when implementing telemedicine across medical specialties. In order to harness this technology, recommendations are directed at organizations that need to evaluate new technologies differently and change their behavior with respect to competitors. Public policy needs to recognize the need for a greater thrust in long-term investments in telemedicine research, greater awareness of telemedicine in medical education and in taking the lead in developing standards, guidelines and protocols for telemedicine networks. Research also needs to be encouraged in newer clinical areas and existing standards and technologies in mature telemedicine application areas such as teleradiology and telepathology may be used in medical specialties where telemedicine is not yet a mainstream application. Moreover, the technology needs to become more 'human-centered' , to reduce technology barriers for both providers and patients amongst whom the elderly may be predominant. / by Shaheen Malik. / S.M.

Thesis (S.M.)--Massachusetts Institute of Technology, Engineering Systems Division, Technology and Policy Program, 2006. / Includes bibliographical references (p. 93-95). / A plant can be considered to be capture-ready if, at some point in the future it can be retrofitted for carbon capture and sequestration and still be economical to operate. The concept of capture-ready is not a specific plant design; rather it is a spectrum of investments and design decisions that a plant owner might undertake during the design and construction of a plant. Power plant owners and policymakers are interested in capture-ready plants because they may offer relatively low cost opportunities to bridge the gap between current coal-fired generation technologies without CO2 capture to future plants that may be built from the start to capture CO2, and reduce the risks of possible future regulations of CO2 emissions. This thesis explores the design options, technologies and costs of capture-ready coal-fired power plants. The first part of the thesis outlines the two major designs that are being considered for construction in the near-term - pulverized coal (PC) and integrated gasification/combined cycle (IGCC). It details the steps that are necessary to retrofit each of these plants for CO2 capture and sequestration. Finally, for each technology, it provides a qualitative assessment of the steps that can be taken to reduce the costs and output de-rating of the plant after a retrofit. / (cont.) The second part of the thesis evaluates the lifetime (40 year) net present value (NPV) costs of plants with differing levels of pre-investment for CO2 capture. Three scenarios are evaluated - a baseline supercritical PC plant, a baseline IGCC plant and an IGCC plant with pre-investment for capture. This analysis evaluates each technology option under a range of CO2 tax scenarios and determines the most economical choice and year of retrofit. The results of this thesis show that a baseline PC plant is the most economical choice under low CO2 tax rates, and IGCC plants are preferable at higher tax rates. Little difference is seen in the lifetime NPV costs between the IGCC plants with and without pre-investment for CO2 capture. The third part of this thesis evaluates the concept of CO2 "lock-in". CO2 lock-in occurs when a newly built plant is so prohibitively expensive to retrofit for CO2 capture that it will never be retrofitted for capture, and offers no economic opportunity to reduce the CO2 emissions from the plant, besides shutting down or rebuilding. The results of this analysis show that IGCC plants are expected to have significantly lower lifetime CO2 emissions than a PC plant, given moderate (10-35 $/ton CO2) initial tax rates. / (cont.) Higher (above $40) or lower (below $7) initial tax rates do not result in significant differences in lifetime CO2 emissions from these plants. Little difference is seen in the lifetime CO2 emissions between the IGCC plants with and without pre-investment for CO2 capture. / by Mark Bohm. / S.M.

Thesis (S.M.)--Massachusetts Institute of Technology, Engineering Systems Division, Technology and Policy Program, 2006. / Includes bibliographical references (p. 74-76). / Access to straightforward yet robust tools to quantify the impact of renewable energy resources on air emissions from fossil fuel power plants is important to governments aiming to improve air quality and reduce greenhouse gases at least cost. It is also important to renewable energy developers seeking to gather support and facilitate permitting of their projects. Due to the inherent complexities of the electric power system, it is difficult to determine the effects of renewable energy generators on emissions from fossil fuel power plants. Additionally, because there are a variety of methods for calculating "avoided emissions," which differ in complexity and transparency, and which provide dissimilar results, there remains uncertainty in estimating avoided emissions. Guidance from government authorities on which method to use is too flexible to provide a robust framework to enable decision makers to evaluate environmental solutions. This thesis informs decision making first by highlighting important issues to consider when analyzing the impact of renewable energy resources on emissions, then by reviewing current guidance on the matter, and finally by comparing existing methods of calculating avoided emissions. Several methods are further evaluated by applying them to potential offshore wind energy resources in New England, including the proposed Cape Wind project. / (cont.) This analysis suggests that the potential avoided emissions of the Cape Wind project are significant, though lower than previously stated by the project developers and supporters. The usefulness of the available literature on calculating avoided emissions suggests that governments and electric industry analysts should continue to share information on different methods and work together to revise the current guidance. To further increase analytical capacity, government agencies should collect, organize, and disseminate more data on the electricity system including power plant operations and emissions. The ability to accurately quantify avoided emissions will help policymakers design programs with the right incentives to reduce emissions from power plants and will enable them to describe the environmental benefits of doing so. To facilitate development of clean energy resources, it is proposed that more weight is given to environmental benefits such as avoided emissions in environmental impact assessments. To assist in reducing emissions, it is recommended that renewable energy and energy efficiency resources are allowed to participate more directly in emissions markets. / by Michael Peter Berlinski. / S.M.

Thesis (S.M.)--Massachusetts Institute of Technology, Engineering Systems Division, Technology and Policy Program, 2007. / Includes bibliographical references (p. 83-86). / In this thesis, the control of hypertension provides the backdrop for my effort to investigate how clinical trial design has evolved for antihypertensive drug submissions reviewed and approved by the Food and Drug Administration between 1988 and 2001. To do this, I have constructed and undertaken a preliminary analysis of a number of quantitative surrogate measures of complexity and scale, such as trial design, numbers of patients, treatment lengths, active drug comparators, number of indications pursued, number of indications approved, and approval times. In addition, I review how practice guidelines for the treatment of hypertension have changed with advancing clinical and biological knowledge. I attempt to investigate whether a link exists between the changing characteristics of clinical trials for antihypertensive therapies and the evolving guidelines for treating hypertension, promulgated by the Joint National Committee Report on the Detection, Evaluation, and Treatment of High Blood Pressure, (JNC), a committee assembled by the National Heart, Lung, and Blood Institute. / (cont.) Although the number of New Drug Applications (NDAs) examined in the antihypertensive class is too small to permit rigorous statistical analyses, I am nonetheless able to observe a number of apparent trends within the set of NDA submissions for antihypertensives approved by the FDA. Specific trends I observe in support of increasing trial complexity include: 1) trial sizes increase over time as measured by patient enrollments per trial (p-value = 0.003); 2) clinical trial designs over time have included greater numbers of arms per trial (p-value = 0.022); and 3) the number of drug-drug interaction studies in antihypertensive NDAs has increased with time (p-value = 0.027). These trends offer preliminary support for the hypothesis that clinical trials associated with NDA applications for antihypertensives have become more complex over the last two decades. The mechanisms responsible for the observed increase in complexity are less clear. Based on available information, I cannot determine if FDA guidance documents or informal correspondence were responsible for making antihypertensive clinical trials more complicated, or whether pharmaceutical companies introduced greater complexity into the trial design for commercial reasons. / (cont.) Furthermore, while I observe that FDA guidelines did not precisely track changes in JNC guidelines for treating hypertension, it is not clear whether the discrepancies are meaningful. Future research might attempt to identify more precisely the causes of increasing clinical trial complexity, and attempt to relate trial complexity to the cost of drug development more generally. / by John Simon Howe MacNeil. / S.M.

Thesis (S.M.)--Massachusetts Institute of Technology, Engineering Systems Division, Technology and Policy Program, 2002. / Includes bibliographical references (p. 109-113). / A study was carried out on policies to address the environmental damage caused by urban public transportation in megacities. Policy recommendations were proposed to alleviate the environmental impact of transportation in two existing megacities, Mexico City and Guangzhou City, using lessons learned from previous experiences in two industrialized countries, the US and Japan. The objectives of this study were as follows: - Review the environmental problems caused by urban transportation; - Examine policies previously tried in developed countries to counter the problems; - Examine methodologies to evaluate external costs of urban transportation from the perspective of environmental sustainability; - Propose, on the basis of case studies, measures to alleviate the environmental impact of transportation in existing megacities. The megacities of Mexico City, Guangzhou City, and Tokyo are suffering from similar environmental problems caused by transportation such as local air pollution of ozone, NOx and suspended particular matter. The causes of pollution such as lack of both internalizing environmental externalities and long-term perspective are common. Policy recommendations were made for each mega city, taking into account the city's historical, cultural, and political background. Through the case studies, the importance of proper enforcement of the policies as well as well-planned transportation policies was found. Only integrated transportation and environment policies and effective policy implementation will enable the recommendations proposed here to achieve the goal of more sustainable urban transportation systems. / by Mimi Takayanagi. / S.M.

Thesis (S.M.)--Massachusetts Institute of Technology, Engineering Systems Division, Technology and Policy Program, 2007. / Includes bibliographical references (p. 171-179). / Globalization is changing the way in which the world is organized. The world trade regime is increasingly the dominant mode of organizing international relations. Within this context of globalization and liberalization of trade, empirical examples of a race to the bottom co-exist with examples of a race to the top and examples of stable heterogeneity of international standards. The puzzle, then, is to determine the structural conditions, sources of power, and policy instruments that determine whether international standards will diverge or converge, upward or downward. This research seeks to reveal the potential for (and limitations of) a race to the top in international standards. System dynamics modeling and theories of globalization and regulatory competition are applied to three case studies to explore the causes of a race to the top: the Montreal Protocol on Ozone Depleting Substances, dolphin-safe tuna, and fair trade coffee. Many of the concerns of a race to the bottom pertain to process and production methods (PPMs) in global supply chains. One of the themes in this research is the distinction between standards based on the characteristics of a product and standards based on the process and production methods (PPMs) used to produce the product. Whereas product standards can be monitored and enforced at the point of market access, PPM standards must be monitored and enforced at the site of production, which can be problematic in global supply chains. This research seeks to elucidate the sources of power and policy levers available to promote higher PPM standards within the context of globalization and the liberalization of trade. / (cont.) A set of theories from international law and political economy is selected to create a theoretical framework for analyzing the effects of globalization on international standards. In particular, theories of corporate power, corporate social responsibility, norm change and consumer power elucidate the potential and limitations of voluntary standards. Theories of regulatory capture and competition inform the question of how voluntary standards translate into public policy. The goal is to understand how social and environmental objectives can be promoted within the context of liberalized trade. / by Diane Cameron. / S.M.

Thesis (S.M.)--Massachusetts Institute of Technology, Engineering Systems Division, Technology and Policy Program, 2006. / Page 184 blank. / Includes bibliographical references (p. 179-181). / Over the last decade, many companies in industries that produce complex and technologically-advanced products have begun to integrate their operations along the value chains of the primary products they design, produce or sustain. Increasingly, integration efforts have moved beyond the boundaries of the core or focal enterprise serving as the prime contractor or system integrator to span the entire value chain, to form virtual extended enterprises. These structures allow the members of the virtual extended enterprise to focus on their core competencies in order to collaboratively deliver a world-class product at a competitive price. While integration offers many benefits to enterprises, a high degree of integration is not always desirable or advantageous in a limited duration virtual extended enterprise composed of autonomous companies. Virtual extended enterprises must find a balance between decoupled collaboration and highly coupled integration, balancing the need to closely coordinate their efforts with the need protect the autonomy of their members. The objective of this research is to explore the extent to which a focal enterprise, such as a prime contractor or system integrator, should consider integration across its virtual extended enterprise, identify major barriers to integration, and define key enablers of integration overcoming these barriers. / (cont.) Analysis focuses on the extent of integration based on the characteristics of the virtual extended enterprise, such as the duration and scope of the program in question, product system architecture, the organizational architecture, and the external environment. In particular, three key conceptual dimensions of integration are developed and explored-technological integration, strategic integration, and organizational integration. This framework is applied in an in-depth case study of integration strategies on the virtual extended enterprise of the F-35 Joint Strike Fighter (JSF) Program. The knowledge gained from the case study is used to make recommendations for the development of integration strategies for future programs. / by Christopher G. Glazner. / S.M.

Thesis (S.M.)--Massachusetts Institute of Technology, Technology and Policy Program, 2001. / This electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections. / Includes bibliographical references (p. 128-132). / by Frédéric Mahoué. / S.M.

Thesis (S.M.)--Massachusetts Institute of Technology, Engineering Systems Division, Technology and Policy Program, 2004. / Includes bibliographical references (leaves 74-76). / Climate change is increasingly being recognized by governments, industry, the scientific community, and the public as an issue that must be dealt with. Parties are pursuing various strategies to reduce CO₂ emissions. Renewable energy, energy efficiency, cleaner fuels, terrestrial CO₂ sequestration, and geologic CO₂ capture and storage (CCS) are the major efforts underway. This thesis examines some major regulatory and political issues that may affect geologic sequestration projects in the future. CCS is a technology system that captures CO₂ from a point source (e.g. power plant or industrial facility), pressurizes it into liquid form, transports it, and finally injects it underground into a porous geology for long-term storage. Technical and economic issues of capture, transportation, and injection of CO₂ have been relatively well studied over the past decade. The impacts of how current environmental regulation and political action to curb climate change will affect CCS have not been thoroughly explored. This thesis investigates the Environmental Protection Agency's Underground Injection Control Program and several types of protected and restricted land use areas to evaluate where it would be difficult or impossible to site a CCS project. I also explore state-level action on climate change and categorize them based on their attractiveness for CCS projects. I suggest a methodology for incorporating this regulatory information into a geographic information system based decision analysis tool, designed to aid decision makers dealing with CCS. / by Adam Smith. / S.M.

Thesis (S.M.)--Massachusetts Institute of Technology, Technology and Policy Program, 2000. / Includes bibliographical references (leaves 176-180). / Innovation and high growth technological companies have been set as a priority in Europe. Recently, the European Union declared "Entrepreneurship and Innovation are central to the creative process in the economy and to promoting growth, increasing productivity and creating jobs. Entrepreneurs sense opportunities and take risks in the face of uncertainty to open new markets, design products and develop innovative processes.'' The most innovative firms, which seek early-stage, external financing, have the potential promise of substantial returns but a concomitant high level of risk. It is within the context of such firms that the potential of venture capital, as a source of entrepreneurial support, appears most relevant. However, many barriers hinder the development of venture capital in Europe, and in particular in France. Innovators are not only vulnerable at the outset but are faced with an interminable series of obstacles to creativity. The main handicaps and obstacles are those affecting the coordination of efforts, human resources, private or public financing and the legal and regulatory environment. This thesis analyzes the current situation of venture capital and entrepreneurship in France, compares it to the overall situation in Europe and in the United States. It eventually delvers some policy recommendations aimed at fostering both the supply and demand of venture capital in France. The main challenge is probably best summarized as one of flexibility. Regulations and procedures of all sorts need to be re-engineered to encourage and promote the fluid development of businesses. Flexibility to adopt new cultural mindsets: risk-taking behavior, different attitudes towards initiative, success and failure. Flexibility to adopt a lifelong learning attitude and regularly retrain. Ultimately, entrepreneurship and the development of venture capital in France is about action rather than analysis, and, despite its high potential, France has still much to achieve. / by James H. Reynolds. / S.M.