Ultra-wideband (UWB) communications has emerged as a promising technology for high data rate wireless personal area networks (WPANs). Several proposals for UWB-based WPANs have been made. One widely popular proposal is based on multi-channel OFDM. This proposal was recently standardized by European Computer Manufacturers Association (ECMA). In this dissertation, we address several important aspects that impact the performance of OFDM-based UWB systems. First, we propose an interference management distributed reservation protocol (IMDRP) for these communications. IM-DRP aims at reducing interference between uncooperative beacon groups that operate simultaneously over the same area. We then integrate IM-DRP into the design of a rate adaptation strategy that exploits the multi-rate capability of OFDM-based UWB systems. Besides maintaining a target packet error rate, our proposed strategy attempts to reduce the required reservation time over a link, hence allowing more links to be concurrently activated. Second, we propose a novel overhearing-aware joint routing and rate selection (ORRS) scheme. For a given source-destination pair, ORRS aims at selecting a path and its transmission rates that achieve the minimum channel reservation time, leading to low blocking rate for prospective reservations and high network throughput. At the same time, ORRS takes advantage of packet overhearing, a typical characteristic of broadcast communications. Finally, we propose a novel resource utilization mechanism (RUM) for improving the throughput in multi-rate UWB-based WPANs. RUM exploits opportunistic-relaying and time-spreading techniques to improve link reliability and increase the transmission rate, and hence network throughput. Simulation results indicate that our proposed protocols and schemes achieve significant throughput improvement compared with other protocols.

Objective: Since its implication, case payment system prevailed and increased cases number in the following years. Hospitals in Taiwan face continous challenge with emerging policies such as global budget and TW-DRG system, which is soon on the way. Remarkable medical resource comsuption is seen in patients with congenital heart deseases, with presence of structural heart defects at birth. The corrective treatment of congenital heart diseases, surgical and transcather, is usually undertaken in large-scale Hospitals in Taiwan.Congenital heart diseases. Items of case payment for congenital heart diseases treatment were implented years ago. However, in the literature there is yet no research about the results of its implentation. This study focus on three objectives: 1.To study of medical resource consumption of case payment system with congenital heart diseases. 2.To study the effect of patient and provider attributes on medical resource consuption in the case payment with congenital heart diseases. 3.To provide the evidence-based information for forcoming NHI policies. Materials and Methods: Retrospectively, claims data from Bureau of National Health Research Insurance (BNHI) for resource utilization of case payment for congenital heart diseases was analyzed. The data includes DD(Inpatient expenditures by admissions) and HOSB(Registry for contracted medical facilities) files ranged from 1997 to 2005. Data items meeting the criteria of both CHD and case payment were extracted. The relationships between patient factors (age, sex, DRG code), healthcare provider (contract type, accreditation type, ownership, area) and resource utilization (length of stay, expenditure) were studied. Results: A total of 4,366 admissions for CHD case payment was enrolled. The mean patients¡¦ age is 14.56 years. Female accounts for 55.46 % of the admissions. Among them there are 3954 open heart surgeries and 412 transcatheter treatments. Average hospital day is 11.6 and 3.37 days respectively. Average payment per case is NT$215,355 and NT$61,819 respectively. Different degrees of resource utilization occur with different patient or hospital characteristics, with statistical signifcance. More resource utilization tends to occur in extremes of age groups, e.g., newborn and elderly populations, regardless open heart surgery or transcatheter treatment cases. Also more hospital fee occurred in private hospital than public hospital, but less in medical centers when compared to metropolitian hospitals. For regression analysis of dependence of resource consumption on patient and hospital factors, the overall power of explanation is higher in transcather treatment cases. Among the factors influencing medical resource utilization, age_group and ownership are respectively the most significant factors. Conclusion: We have verify the hypothesis in this study, which emphasize that resource utlization differs by different patient and hospital factors. The pattern of resource utilization for this unique disease (CHD) and its discrepancy with concurrent payment criteria are evaluated in this study. Based on our results, adjustment of payment criteria should be reasonable to ensure early and adequate treatment for these patients. Thus this study provides strong insight for implication of TW-DRG for disease management. Further study will include aspects of resource utlization such as direct, indirect costs, tangle and intangle, and related complication and comorbidities.

Successful treatment of chronic hepatitis C virus (HCV) leads to significant benefits in both hepatic and extrahepatic morbidity and mortality. However, treatment is costly and onerous. The purpose of this study was to evaluate the resource utilization and healthcare costs of chronic HCV patients who are treated versus those who are not treated. Patients eligible for this study were Texas Medicaid patients ≥18 and ≤63 years who had evidence of chronic HCV during the identification period (1/1/07-9/30/11) and continuous enrollment throughout the analysis period. High dimensional propensity scoring techniques were used to match treated vs. untreated patients (1:2 ratio). Unadjusted and adjusted analyses compared the healthcare costs and utilization between patient cohorts at 6 and 18 months. For those treated, adherence was measured by proportion of days covered and persistence was evaluated as a gap in medication (of one fill) as determined by refill records. There were a total of 24,032 patients identified with chronic HCV. After high dimensional propensity scoring, there were no significant differences in key clinical and demographic characteristics between treated (n=939) and untreated (n=1878) cohorts. Over 97% of patients had evidence of end stage liver disease at baseline. Based on adjusted analyses of total costs using a generalized linear regression model, the mean difference in costs between the treated vs. untreated patients was $13,960 (SE $458, p<0.001). At 18 months of follow-up, the adjusted mean all-cause costs were $20,834 higher for treated patients (n=456) compared to those untreated (n=849) (p<0.001); however, mean outpatient costs were $1,894 (SE $274) less in treated vs. untreated patients. For those treated, the average HCV medication PDC was 71%, and by the end of 24 weeks, only 42.3% of patients remained on HCV therapy. This study did not show short-term cost offsets, but the sub-analysis following patients for 18 months showed trends in downstream cost offsets. Most patients had advanced liver disease, reducing the chances of successful treatment and averting liver disease sequelae. Earlier identification and treatment could bend the cost curve before these patients reached the more advanced stages seen in this costly cohort. / text

Today’s economic conditions force companies and organizations to work more effectively in their processes due to different reasons.  Especially; after the Second World War, owing to the changing business perception and strong competition between companies, new terms such as productivity, flexible systems, efficiency, and lean came into industrial engineering discipline. However, these kinds of terms also brought a new question. How are they reached?  At that point, discrete event simulation has been used as an effective method to give an answer to this question. From this perspective; this project focuses on discrete event simulation and its role in real industrial processes. The main interest of this paper is discrete event simulation, but in this study we also tried to give some detailed information about other types of simulations such as continuous and discrete rate. Basically, we can say that this paper consists of several parts. In the beginning of this paper, the reader can find some theoretical information about simulation itself and the requirements for implementing it on real processes. Secondly, we tried to explain different types of simulations and the reason why we used discrete event simulation instead of continuous or discrete rate in our case study. Furthermore, one of the main areas of this research is to inform the reader about how computer support is used as a simulation tool by today’s companies. To do this, a powerful software, Extendsim8, is described in detail.  The reader is able to find all the information about how to create discrete event models in this software. In case study part, we are able to find the results of the five months work that we did between February and June at GKNDriveline Köping AB in Sweden. In these five months, we had been busy with analyzing an assembly line, collecting data, creating a simulation model, discussion with workers and engineers and doing some tests such as validation &amp; verification. In this part, the reader can find all the information about the production line and the simulation model. In conclusion, reader can find the results of the project at the end with the visualization of future state. As it will be discussed repeatedly in the paper, validation is one of the important steps in a simulation project. Therefore, in order to see the reliability of our simulation model, different calculations and tests were made. Last of all, some of results will be shown by graphs and tables in order to give better insight to reader.

Health care spending in Canada has been increasing faster than the rate of gross domestic product (GDP). A disproportionate amount of the health care spending is allocated to care of older adults. Non-elective abdominal surgery is an expensive area of care for older adults. Despite this, the factors associated with cost in this patient population remain unclear. OBJECTIVES The primary objective of this study was to estimate the association between perioperative factors (age, American Society of Anesthetists (ASA) classification, operative severity (OS), frailty index (FI), complication severity) and health care costs among older adults undergoing non-elective abdominal surgery. The secondary objectives were: 1. to provide a comprehensive description of costs based on patient-level resource utilization; and 2. to examine the relationship between hospital costs and adverse events (non-fatal complication severity, mortality, and change in living arrangement). METHODS This study was an observational prospective cohort study. Over a 15 month period all patients 70 years or older who underwent non-elective abdominal surgery at the QEII Health Sciences Centre, Nova Scotia, were enrolled. Data were collected on patient demographics, investigations, treatments, and outcomes. Direct hospital health care costs (2012 $CAD) were calculated by tabulating patient-level resource use and assigning specific costs. The association between five perioperative factors and costs were analyzed using univariate non-parametric tests and multiple linear regression. The associations between adverse events and costs were assessed using univariate non-parametric tests and multiple linear regression. RESULTS During the study period, 212 patients who underwent abdominal surgery (median age 78 years (range 70-97)) were enrolled. The median costs of care were $9,166 (range $1,993-$104,403). The largest proportions of spending were non-procedural costs (65% [$2,176,875]) and intensive care costs (16% [$554,523]). The perioperative factors ASA classification (p=0.0010), OS (p<0.0001), FI (p=0.0002) and complication severity (p<0.0001) were all independently associated with health care costs, while age was not (p=0.5330). The following adverse events were independently associated with health care costs: non-fatal complication severity (p<0.0001), change in living arrangement (p=0.0002), and mortality (p=0.0337). Non-fatal complications had the strongest association with hospital costs (standardized β coefficient = 0.3931). CONCLUSION Four perioperative factors (ASA, OS, FI and complication severity) are associated with costs; therefore, representing a potential cost prediction model for this patient group. This study is important for health care administrators, identifying targets for cost reduction. Cost reduction strategies and research should concentrate on mitigating or preventing complications and high cost areas, such as non-procedural costs and intensive care, in order to achieve cost savings.

AN ABSTRACT OF THE THESIS OF Abdulaziz M. AlNowiser, for the Master of Science degree in Computer Science, presented on November 1, 2013, at Southern Illinois University Carbondale. TITLE: TOWARD ENERGY-EFFICIENT SCHEDULING USING WEIGHTED ROUND- ROBIN AND VM REUSE MAJOR PROFESSOR: Dr. Michelle M. Zhu In recent years, the rapid evolving Cloud Computing technologies multiply challenges such as minimizing power consumption and meeting Quality-of-Services (QoS) requirements in the presence of heavy workloads from a large number of users using shared computing resources. Powering a middle-sized data center normally consumes 80,000kW power every year and computer servers consume around .5% of the global power [1]. Statistics for 5000 production servers over a six-month period show that only 10-50% of the total capacity has been effectively used, and a large portion of the resources is actually wasted. In order to address the skyrocket energy cost from the high level resource management aspect, we propose an energy efficient job scheduling approach based on a modified version of Weighted Round Robin scheduler that incorporates VMs reuse and live VM migration without compromising the Service Level Agreement (SLA). The Weighted Round Robin scheduler can monitor the running VMs status for possible VM sharing for job consolidation or migration. In addition, the VMs utilization rate is observed to start live migration from the over-utilizing Processing Element (PE) to under-utilized PEs or to the hibernated PEs by sending WOL (Wake-On-LAN) signal to activate them. The simulation experiments are conducted under the CloudReports environment based on open source CloudSim simulator. The comparisons with other similar scheduling algorithms demonstrate that our enhanced Weighted Round Robin algorithm (EWRR) can achieve considerable better performance in terms of energy consumption and resource utilization rate.

The technology push by Moore's law brings a paradigm shift in the adaption of many core systems which replace high frequency superscalar processors with many simpler ones. On the software side, in order to utilize the available computational power, applications are following the high performance parallel/multi-threading model. Thus, many-core systems raise the challenges of resource allocation and fragmentation making necessary ecient run-time resource management techniques. In this thesis, we propose SPA, a Simple Pool Architecture for managing resource allocation in many-core systems. The proposed framework follows a distributed approach in which cores are organized into clusters and multiple clusters form a pool. Clusters are created based on system's characteristics and the allocation of cores is performed in a distributed manner so as to increase resource utilization and reduce fragmentation. Specifically, SPA is responsible (i) to generate the pool-based structure and organize cores into clusters depending on the NoC architecture; (ii) to serve, at run-time, the needs of multithreaded applications, in terms or processing cores; and (iii) to allocate resources in order to take advantage of spatial features, shared resources and reduce fragmentation. Experimental results show that SPA produces on average 15% better application response time while waiting time is reduced by 45% on average compared to other state-of-art methodologies.

The mine planning process converts resources into economically mineable reserves, focusing on value addition and risk reduction. Equipment selection is traditionally addressed late in the process and addresses production capacity, equipment matching and equipment allocation. The primary focus being to reduce the operating cost per unit of material handled. Mineral resource management is an integration of the key functions in the mining process. A focus on resource utilisation plays a key role in the management process and leads to the question whether lower operating costs always add value in the long term. It was determined that traditional equipment selection methods are not effective for all mineral deposits and might even be short sighted, destroying value over the long term. The mine planning process was adapted to allow for an early investigation into the potential for increased recovery. The effect of selectivity in the loading action is simulated in a 3D environment over a range of bench heights. The results are analysed with a grade tonnage curve and the saleable product at each bench height is calculated, taking account of the required product qualities. The concept of financial materiality is applied to classify the resource as either a massive or selective deposit. A massive deposit support the traditional drive for bigger equipment and will benefit from lower operating costs. A selective deposit requires less focus on production capacity, equipment matching and allocation and more on resource recovery. In order to take advantage of the potential indicated in the evaluation, it is necessary to modify the traditional equipment selection techniques. A thorough understanding of the capabilities of the loading equipment is required in an attempt to match these abilities with the geometry of the ore deposit. The objective is to identify the equipment that will ensure the highest mining recovery at the lowest cost. This will be achieved when the loading equipment can attain a mining recovery smaller than the bench height it is mining or if the equipment can be applied economically on small bench heights. The most suitable equipment can only be determined at the hand of a total value chain costing analyses. This means that the production cost i.e. the cost to produce the final product must be evaluated and not the operating cost i.e. the cost to move a unit of material, as is often the case. The proposed mine planning approach and equipment selection technique was used on the Thabazimbi iron ore mine deposits. The results indicated that the NPV of the project could be increased dramatically. It was concluded that the ability to load selectively cannot be calculated mathematically. It is a judgment made on a thorough evaluation of the design and operating features of the shovel in conjunction with the ore body geometric parameters and the loading face conditions. The efficiency of the selected shovel can be manipulated through the application of different bench heights, and the optimum combination can only be determined through a total value chain costing analyses. / Dissertation (MEng (Mining Engineering))--University of Pretoria, 2005. / Mining Engineering / unrestricted

Introduction: Atypical Antipsychotics (AAPs) are approved by the Food and Drug Administration (FDA) for the treatment of schizophrenia and bipolar disorder. AAPs are commonly used off-label to treat depression, post-traumatic stress disorder and neuropsychiatric symptoms in dementia due to lack of alternative treatment options and treatment resistance. Concerns for off-label use arise since AAPs increase the risk of cardiovascular events and death. The objectives were 1) describe patterns of RU and costs among off-label AAPs users in a nationally representative population 2) identify prevalence of off-label use in the Medicare population 3) compare RU and costs between off-label AAPs users and non-users with mental health conditions in Medicare. Methods: For the first objective, the Medical Expenditure Panel Survey (MEPS) datasets were used. AAPs users greater than 18 years were identified in this cross-sectional study. Generalized Linear Models (GLM) were used to estimate costs among users and non-users after controlling for age sex, gender, insurance type, marriage status, income and comorbidity index. For the second and third objective, Medicare datasets were used to identify prevalence, RU, and costs of off-label use in Medicare beneficiaries 18 years and older. RU and costs between propensity score matched AAPs user and non-user cohorts were compared in a retrospective cohort study. Results: The adjusted odds of having an office-based outpatient (OR=2.47, 95%CI: 1.55-3.92) or inpatient (OR=1.63, 95%CI: 1.26-2.10) visit were significantly higher among off-label AAPs users. Adjusted office-based visit ($1,943 vs. $1,346), prescription ($4,153 vs. $1,252) and total ($10,694 vs. $4,823) costs were significantly higher among users (p<0.0001). Among Medicare beneficiaries, approximately 37% of AAPs users had no FDA approved diagnosis. The typical off-label user was a white 70-year-old male. Common off-label uses were depression, anxiety and neurotic disorders and dementia. Off-label AAPs users had significantly higher mental health outpatient ($461 vs $297), prescription ($2,349 vs $282) and total ($3,665 vs $1,297) costs per beneficiary than non-users. About 30% of AAPs users had at least one mental health outpatient visit during the year versus 23% of non-users; no significant differences were found in inpatient visits. AAPs non-users had significantly higher all-cause inpatient costs ($6,945 vs. $4,841) per beneficiary (p Conclusion: In a nationally representative population comprising a younger age group AAPs users had higher all-cause RU and total costs than non-users. Off-label prescribing of AAPs continued to be a prevalent practice affecting 37% of Medicare AAPs users. Off-label AAPs users had higher mental health costs but no significant differences in all-cause total health care costs in a Medicare population. Off-label use of AAPs can be a cost-effective option if future research shows off-label use is associated with increased effectiveness, which offsets any additional costs.

<p>This paper presents the feasibility study of setting up the new potting tray production line based on the two alternatives: partly outsource a process in the production line or wholly make all processes in-house. Both the qualitative and quantitative approaches have been exploited to analyze and compare between the make or buy decision. Also the nature of business, particularly SMEs, in Thailand has been presented, in which it has certain characteristics that influence the business doing and decision, especially to the supply chain management. The literature relating to the forecasting techniques, outsourcing decision framework, inventory management, and investment analysis have been reviewed and applied with the empirical findings. As this production line has not yet been in place, monthly sales volumes are forecasted within the five years time frame. Based on the forecasted sales volume, simulations are implemented to distribute the probability and project a certain demand required for each month. The projected demand is used as a baseline to determine required safety stock of materials, inventory cost, time between production runs and resources utilization for each option. Finally, in the quantitative analysis, the five years forecasted sales volume is used as a framework and several decision making-techniques such as break-even analysis, cash flow and decision trees are employed to come up with the results in financial aspects.</p>