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As the EU and the US successively proposed the carbon border adjustment mechanism (CBAM) and the Clean Competition Act (CCA), importers are now required to declare the carbon emissions of their products. Particularly, wheel companies face increasing time pressure with the gradual development of implementation paths for net-zero emissions and implementing carbon pricing policies in various countries. This research uses the production data of Taiwan wheel companies to establish a mathematical model for the activity-based cost optimisation decision-making process. It explores the impact of different carbon emission costs on a company's product mix with pricing decisions. Further, the research proposes five mathematical programmes for single-period cost optimisation decision-making under carbon pricing. These models provide some detailed view, such as changes in profits and product mix caused by high carbon taxes or other changes for each resource. Furthermore, the production cost optimal model proposed in this research can be used by enterprises to fulfill their social responsibilities while ensuring profitability and serve as a reference for making net-zero transformation decisions. [ABSTRACT FROM AUTHOR]

This paper is born of the joy and pain of institutional life. It responds to recent work by Craig Thompson and is a response to an invitation to participate from the Editor of the JMM (Mark Tadajewski). It seeks to take seriously the role of consumer research and consumption within society. It seeks to tell 'better stories' about the past, present and what it sees as a reimagined future for consumer research. To do so, it revisits some of the canonical works of consumer research, such exemplary work it suggests are worthy of revisiting and critiquing if we are to chart a rejuvenated form of consumer research that takes seriously our contemporary predicament and is more critical and incisive in its intent. With renewed purpose it takes on board the insights around Bauman's notion of 'liquid times', offers a range of opportunities, possibilities and dangers around the conflicted consumer self and puts forward an ABC of critical consumer research, where notions of affect, breakdown, contradiction are taken seriously for their theoretical and practical insights. [ABSTRACT FROM AUTHOR]

Integrating low-carbon design into products is crucial for reducing carbon emissions throughout their life cycle and promoting sustainable development. Addressing the uncertainty in the carbon footprint resulting from the unknown choice of product material solutions. This paper considers ABC (activity-based costing) along with the components' carbon footprint and scrap return issues to illustrate the above challenge in a two-stage production-inventory system with imperfect processes. We determine the optimal production and sales strategies that maximize total profit per unit time. An algorithm is developed to identify these optimal solutions. To illustrate the effectiveness of the proposed model and algorithm, two numerical examples from the Taiwan die casting industry are presented. Additionally, a sensitivity analysis is conducted to provide valuable managerial insights. [ABSTRACT FROM AUTHOR]

Study Design. Retrospective study. Objective. To compare the true cost between posterior cervical laminectomy and fusion and cervical laminoplasty using time driven activity-based costing methodology. Summary of Background Data. Cervical laminoplasty (LP) and posterior cervical laminectomy with fusion (LF) are effective procedures for treating cervical myelopathy. A comprehensive accounting of cost differences between LP versus LF is not available. Using time-driven activity-based costing (TDABC), we sought to compare the total facility costs in patients with cervical myelopathy undergoing LP versus LF. Materials and Methods. We conducted a retrospective analysis of 277 LP and 229 LF performed between 2019 and 2023. Total facility costs, which included personnel and supply costs, were assessed using TDABC. Separate analyses including and excluding implant costs were performed. Multiple regression analysis was utilized to assess the independent effect of LP compared with LF on facility costs, with all costs standardized using cost units (CUs). Results. Patients undergoing LP had lower total supply costs [672.5 vs. 765.0 CUs (0.88x), P < 0.001] and lower total personnel costs [330.0 vs. 830.0 CUs (0.40x), P < 0.001], resulting in a lower total facility cost both including [1003.8 vs. 1600.0 CUs (0.63x), P < 0.001] and excluding implant costs [770.0 vs. 875.0 CUs (0.88x), P < 0.001] (Table 1). After controlling for demographics and comorbidities, LF was associated with increased total facility costs, including (588.5 CUs, 95% CI: 517.1-659.9 CUs, P < 0.001) and excluding implant costs (104.3 CUs, 95% CI: 57.6-151.0 CUs, P < 0.001). Conclusions. Using time-driven activity-based costing, we found that total facility costs were lower in patients treated with laminoplasty. These findings suggest that laminoplasty may of fer a less costly and more efficient surgical option for treating cervical myelopathy. [ABSTRACT FROM AUTHOR]

Background: In 2016, Uganda introduced services for hypertension and diabetes in selected HIV clinics. We evaluated the costs associated with scaling up these services in HIV clinics in Mbarara and Ibanda districts, Uganda. Methods: We estimated the annual costs of providing hypertension and diabetes services using an activity-based costing approach from the health system perspective in ten randomly selected HIV clinics in Mbarara and Ibanda districts. Cost inputs included 2023 data on costs of medications, health provider time, salaries, training costs, and monitoring costs. We determined the average annual cost and medication costs for hypertension and diabetes treatment per enrolled adult patient, stratified by type of health facility. Results: The total annual cost of hypertension and diabetes management services in ten selected HIV clinics was estimated to be $413,850 (range: $8,386 − 186,973). The annual average clinic-level cost per enrolled patient was estimated at $14 (range: $7 − 31). Of the total annual cost, the cost of provider time for initial and follow-up visits represented the largest cost component in 5/10 clinics (mean: 37%, range [13–58%]). In 4/10 clinics, the major cost components were the costs of medication, diagnostic tests, and related supplies (mean: 37%, range [10–75%]). The average cost per enrolled adult patient was $11 at public facilities and $21 in private not-for-profit facilities. The average medication cost per patient for hypertension was $24 (range: $7 − 97) annually; $13 at public facilities and $50 at private not-for-profit facilities. For diabetes treatment, the average annual medication cost per patient was estimated at $14 (range: $6 − 35); $11 at public facilities and $22 at private not-for-profit facilities. Conclusion: Adding hypertension and diabetes management to routine HIV care might be feasible based on the estimated annual cost per patient. Hypertension and diabetes treatment was more costly in private not-for-profit facility-based clinics than at public facilities. This variation was primarily driven by higher medication procurement prices at private facilities, revealing a potential area for optimizing costs through improved procurement practices. [ABSTRACT FROM AUTHOR]

Background: Access to safe, financial affordable health care is a key factor in reducing health disparities. The malaria is a major public health issue, with significant economic implications in Guinea where the free malaria care services were introduced in 2010. This paper analyzes the costs associated with the care pathway for malaria patients in the Republic of Guinea. Methods: An analysis of the costs associated with malaria disease was conducted using data from a cross-sectional survey on the determinants of malaria care pathway between December 2022 and March 2023. The data were collected in health facilities and at community health workers. According to the patient's perspective, Time-Driven Activity-Based Costing (TDABC) and micro-costing approaches were used to assess the costs associated with care-seeking, cases management, and income loss. Results: A total of 3300 patients were recruited in 60 health facilities. The majority were in urban areas (64.8%). One third of the patients were children under five years old. Over half of the patients or caregivers were without formal education, and most households were headed by husbands (78.5%). The median monthly income of the head of households was $116.0. Furthermore, after diagnosis, 25.5% of cases were uncomplicated malaria, 19.2% were complicated, and 52.2% were malaria associated with other diseases. Globally 41% of cases were on their first care pathway. The costs of care-seeking varied according to type of malaria, from $3.5 and $13.5 respectively for uncomplicated and complicated cases. The median direct costs of case management at health facilities were $7.3 (IQR: $4.1,13.3) for uncomplicated and $30.5 (IQR: 15.7, 51.4) for complicated cases. The total costs associated with the global care pathway differed across types of malaria and age groups, with median costs estimated at $17.4 (IQR: 6.7, 34.8) for uncomplicated cases and $43.5 (IQR: $ 19.7, 74.0) for complicated malaria. A delay in appropriate care-seeking accounted for 19% of the costs incurred by malaria patients in Guinea (p < 0.001). Conclusion: Despite the introduction of free malaria prevention services, malaria patients or their caregivers continue to incur costs and loss of income. An approach to selective, free and affordable flat-rate costs could ensure the financial viability of health facilities and reduce out-of-pocket expenses. The next research will focus on the impact of free selective and flat-rate pricing on out-of-pocket expenses, and the analysis of the perception of the malaria care services by care providers and users. [ABSTRACT FROM AUTHOR]

The article analyzes the types of assessment of police activity through the prism of the conceptuality of the concept of «effectiveness», the general scientific features of which are: 1) the inherent nature of the category «effectiveness» of an evaluative nature; 2) display with its help the level of achievement of the goal of the activity and taking into account the costs and resources spent for this; 3) implementation of the characterization of the level of efficiency using quantitative and qualitative criteria, the system of which is not stable and may change depending on a number of factors of an objective and subjective nature. It was emphasized that the evaluation of the effectiveness of police activity should be based on the ratio of the obtained result and the costs and resources spent for it. We defined the classification of types of evaluation of the effectiveness of police activity as the process of grouping them according to the signs of kinship and difference. In the presented study, the scientific provisions regarding the classification of types of evaluation of the effectiveness of police activity were further developed. The author’s classification of the types of evaluation of the effectiveness of police activity is proposed, which are divided: depending on the entity that performs the evaluation into state (supra-departmental and departmental) and public; depending on the scale of the national and territorial assessment; depending on the object of assessment for general, special, personal; depending on the content of the statistical and sociological assessment. It is emphasized that the identified criteria are not mutually exclusive, as the evaluation of policing usually involves a combination of different types to obtain a complete comprehensive picture of the effectiveness of policing and may take into account the specific needs and requirements of each region or law enforcement agency. It is noted that the classification of the types of evaluation of the effectiveness of police activity is purely theoretical in nature and allows for a more in-depth clarification of its content and legal nature. [ABSTRACT FROM AUTHOR]

Background Purpose Methods Results Conclusion Total‐body positron emission tomography (PET), already well‐established in the pre‐clinical setting, makes it possible to study multi‐parameters in biological systems as a whole, rather than focusing on single tissues analysis. Simultaneous kinetic analysis of multiple organs poses some daunting new challenges.To explore quantifying the pharmacokinetics of Na[18F]F in multiple dissimilar murine organs simultaneously in vivo with total‐body PET imaging using different compartmental models for each organ and a shared cardiovascular system.Six mice underwent a 60‐min total‐body PET scan following intravenous bolus injection of Na[18F]F. Compartmental models were constructed for each organ (heart, lungs, liver, kidneys, and bone) using an image derived input function. Non‐linear least squares fitting of a model that connects the five organs to a shared cardiovascular system was used to analyze both the first 3 min of data and the full hour. Analysis was repeated 5000 times using different initial parameter values for each duration, permitting analysis of correlations between parameters.The models give a good qualitative account of the activity curves irrespective of the duration of the data; however, the quality of the fits to 3 min of data (average χν2$\chi _\nu ^2$ is 2.72) was generally better. Comparison of perfusion values to literature values was possible for the liver and lungs with the former (liver, 0.540 ± 0.177 mL/ml/min) being well‐above expectations and the latter (lungs, 0.184 ± 0.413 mL/ml/min) in rough agreement. Correlations between microparameter values (especially affecting k2) caused very noticeable problems for data modeling from both the kidneys and the femur.The present study demonstrates an approach to performing kinetic modeling for multiple organs simultaneously with Na[18F]F. The observed correlations between microparameter values remain a challenge. Nonetheless, many microparameters can be estimated reliably with a quantitative analysis of perfusion being possible for some organs. [ABSTRACT FROM AUTHOR]

This article approaches the mystery of preference formation – a blind spot in the capability approach – from the angle of aspiring. I argue that aspiring – actively engaging with desirable representations of potential futures – can be helpful to analyse the social processes involved in preference formation under two conditions. Firstly, we need to clarify the conceptual confusion around aspiring that can be found in the capability literature and beyond. Secondly, we need to consider the social and temporal embeddedness of aspiring, which can be done by examining the relationships between aspiring and people's lived experiences. Building on a critical discussion of the contribution of sociologists Alfred Schutz and Pierre Bourdieu to the study of projecting, I propose a framework to (a) analyse why aspiring may happen to lead to conceiving conservative aspirations despite adversity – thereby aligning with adaptive preferences in the sense of Sen, A. 2002. Rationality and Freedom. Cambridge, MA and London: The Belknap Press of Harvard University Press and Elster, J. 1983. Sour Grapes: Studies in the Subversion of Rationality. Cambridge: Cambridge University Press – and to (b) envision the pathways along which aspiring could, alternatively, lead to emergent aspirations, i.e. geared at enhanced well-being. [ABSTRACT FROM AUTHOR]

Background: Cognitive frailty (CF) is an emerging concern among older persons, particularly within lower socioeconomic statuses (SES) populations. Currently, there is limited evidence on the potential reversibility of CF through multi-domain interventions within this demographic. This study aimed to investigate the effectiveness of the WE-RISE™ multi-domain intervention in addressing the potential reversibility of CF among community-dwelling older persons of lower SES, the intervention effects on multiple health dimensions, and to determine if WE-RISE™ is of low cost. Methods: This 24-week randomised controlled trial included 55 community-dwelling older persons of lower SES with CF, who were randomised into either the WE-RISE™ intervention group (n = 27), or the control group receiving usual care (n = 28). The WE-RISE™ intervention comprised of 12 weeks of instructor led, community-based intervention, followed by 12 weeks of WE-RISE™@Home. CF status, cognitive and physical function, nutrition, disability, health-related quality of life, exercise self-efficacy and depression were assessed at baseline, 12th and 24th weeks. Changes in CF status was analysed descriptively, while intervention effects were analyzed with split plot ANOVA. The cost of the WE-RISE™ intervention was calculated using activity-based costing. Results: At baseline, all participants in both the intervention and control groups (100%) were classified as CF. Following 12 weeks of the WE-RISE™ intervention, 74.1% of participants in the experimental group no longer met the criteria for cognitive frailty, with 63% maintaining this improvement at 24 weeks. In contrast, the CF status of participants in the control group remained largely unchanged, with only 10.7% showing improvement at 12 weeks and falling to 3.6% at 24 weeks. Significant intervention effects were observed for cognition, physical function, body composition, disability, health-related quality of life and self-perceived exercise self-efficacy (p < 0.05) following participation in WE-RISE™. The cost per intervention session was RM4.06 (≈ RM3.88), and the cost per subject for 48 sessions was RM194.74 (≈ RM187.01). Conclusion: The WE-RISE™ multi-domain intervention has demonstrated potential in reversing CF among older persons of lower SES, leading to significant improvements across multiple health dimensions at a low cost. WE-RISE™ shows promise to enrich the well-being of ageing societies, contribute to societal health, and ensure equitable access to healthcare, supporting broader implementation by enhancing equitable access to health programs and addressing the needs of older persons, WE-RISE™. Trial registration: This trial was registered in the Australian New Zealand Clinical Trials Registry (ACTRN12619001055190) on the 29th of July 2019 – retrospectively registered. [ABSTRACT FROM AUTHOR]

Background: Time-driven activity-based costing (TDABC) and activity-based costing (ABC) are methods used in the healthcare sector to assess the costs of patient care pathways. These methods help identify opportunities for optimizing and reducing activity times without compromising the quality of care. TDABC is recommended in the Value-Based Healthcare (VBHC) model to assess the outcomes of care pathways in relation to their associated costs. By focusing on the creation of value for patients, TDABC helps identify the interventions and processes that provide the most value in terms of clinical outcomes and patient satisfaction. This enables healthcare organizations to make informed decisions on improvements that will maximize value for patients. The aim of the study is to evaluate the cost of the oncology thoracic surgery care pathway prior to and following the implementation of digital health solution. Methods: We have chosen to use the TDABC and ABC methods to calculate the costs of care pathway for oncology patients undergoing thoracic surgery in two healthcare establishments prior to and following the implementation of a digital health solution. By using these methods, we were able to calculate the costs associated with each stage of the patients' care pathway. This has given us a clearer picture of the costs associated with each activity and a better understanding of the sources of expenditure. Results: The results show that implementing the digital health solution and applying the principles of the VBHC model have provided tangible benefits in terms of reviewing processes and the roles of the various players involved, eliminating unnecessary or non-value-added activities, automating administrative or repetitive tasks, and improving coordination between the two healthcare establishments and between healthcare professionals. These improvements have contributed to better patient care. Conclusions: Given the success observed in this pilot project, decision-makers chose to persistently implement this digital health solution for specific care pathways over the long term. Additionally, there is a commitment to further enhance the platform to align closely with the needs and the expectations of healthcare professionals. This proactive approach aims to ensure optimal utilization of resources, ultimately providing the best care to patients. [ABSTRACT FROM AUTHOR]

Rationale: Anemarrhenae Rhizoma (AR) has been a frequently utilized traditional Chinese medicine (TCM) for an extended period, with its salt‐processed variant being a prevalent application form. Contemporary pharmacological investigations have demonstrated that the salt‐processed iteration exhibits a multitude of markedly augmented pharmacological properties. However, whether the pharmacodynamic material basis of this change is related to volatile substances remains unclear. The aim of this study was to develop a strategy to screen volatile pharmacodynamic substances in AR and salt‐processed AR (SAR). Methods: A comprehensive approach was developed to identify volatile pharmacodynamic compounds by integrating plant metabolomics, target network pharmacology, and molecular docking technology. Plant metabolomics using GC–MS analysis was conducted to identify volatile chemical markers distinguishing between AR and SAR. Subsequently, network pharmacology was utilized to investigate the correlation between chemical markers and associated diseases. Following this, molecular docking technology was utilized to explore the correlation between chemical markers and disease targets, resulting in the discovery of potential quality control markers. Results: Fifty volatile compounds were isolated and identified in the salt of AR and SAR. The findings from plant metabolomics analysis demonstrated a distinct differentiation, revealing 13 volatile chemical markers that distinguish between AR and SAR. A target (PPARG) associated with diabetes was identified through target network pharmacology analysis. Thirteen volatile components were subsequently chosen as potential quality markers, taking into account their hypoglycemic activity. Conclusions: The method developed provides a novel strategy for the identification of pharmacophores in AR and SAR, as well as establishing a foundation for the exploration of the volatile differential components and pharmacodynamics in various processed products of TCMs. Additionally, the findings of this study can serve as a theoretical framework for the development and utilization of volatile components in AR and its processed derivatives. [ABSTRACT FROM AUTHOR]

AbstractConventionally, a first-in-human phase I trial in healthy volunteers aims to confirm the safety of a drug in humans. In such situations, volunteers should not suffer from any safety issues and simple algorithm-based dose-escalation schemes are often used. However, to avoid too many clinical trials in the future, it might be appealing to design these trials to accumulate information on the link between dose and efficacy/activity under strict safety constraints. Furthermore, an increasing number of molecules for which the increasing dose-activity curve reaches a plateau are emerging.In a phase I dose-finding trial context, our objective is to determine, under safety constraints, among a set of doses, the lowest dose whose probability of activity is closest to a given target. For this purpose, we propose a two-stage dose-finding design. The first stage is a typical algorithm dose escalation phase that can both check the safety of the doses and accumulate activity information. The second stage is a model-based dose-finding phase that involves selecting the best dose-activity model according to the plateau location.Our simulation study shows that our proposed method performs better than the common Bayesian logistic regression model in selecting the optimal dose. [ABSTRACT FROM AUTHOR]

The chemical industry, a cornerstone of the global economy essential for modern life, has raised significant concerns due to its unique nature. Chemical technologies often require high energy inputs, involving ecotoxic reagents thus assessing risks from an economic standpoint becomes complex. While the economic aspects of chemical technologies have been discussed and economic tools have been used to inform investment decisions in this field, many fundamental issues remain unexplored, such as the clear definition of chemical technology economics and the reasons for its importance. The primary contribution of this article is to synthesize insights into these fundamental issues and propose pathways for future research in chemical technology economics. This review is divided into two sections: the first provides an overview of the significance of economic factors in chemical technologies, and the second explores the fundamentals of economics and their application to chemical technology considerations. Our research underscores that economic theories significantly influence the profile of chemical technologies, viewing the chemical sector as a dual asset. First, the sector has a unique opportunity to lead the way in promoting sustainable economic development, and second, it can adopt economic behaviors that align with environmental and societal needs. [ABSTRACT FROM AUTHOR]

Background: Health-care costs, often determined through outdated methods, fail to capture the true costs of care delivery. Traditional costing methods in the health-care sector have proven insufficient, leading to potential revenue losses and increased patient out-of-pocket expenses. Activity-based costing (ABC) and time-driven ABC (TDABC) offer alternative approaches to cost calculation, aiming for a more accurate reflection of resource consumption. Methodology: This descriptive observational study was conducted in the magnetic resonance imaging (MRI) center of a tertiary care teaching hospital, focusing on a single noncontrast MRI scan costing. Direct observations and record reviews, including standard operating procedures, policy letters, financial documents, and miscellaneous records, were employed. Results: Using traditional costing, the unit cost of an MRI scan was calculated at INR 1291.51. ABC yielded a unit cost of INR 3613.77, while TDABC resulted in a unit cost of INR 2764.39. A comparison between the three costing methods revealed potential revenue losses with traditional costing. In contrast, TDABC appeared to strike a balance between financial prudence and reduced patient out-of-pocket expenses. Conclusion: The study emphasizes the significance of understanding true costs in health-care delivery. The results advocate for the adoption of TDABC as a favorable compromise, enabling the hospital to retain revenue without burdening patients with additional costs. Notably, the study highlights the necessity for a granular understanding of true costs for successful transitions from volume to value in health care.

Purpose: This research uses bibliometric analysis methods with the aim of determining trends in the application of activity-based costing in various industries. Method: The data used comes from articles published on Scopus and Google Scholar with a time span of 1980 to 2023. The number of articles produced was 1,180 and selected according to the topic of discussion, resulting in 946 articles used as research data. Researchers use several software programs in research, such as Publish or Perish to obtain research data, Mendeley and Excel to help select data, and VOS viewer to process research data. Results: The research results showed that there were 946 scientific papers that generated 58,915 citations; in addition, there were several researchers, journals, and publishers that were influential in activity-based costing research. The bibliometric map produces five clusters of different importance. Implications: Theoretically, the results of this research provide a more in-depth view of research trends regarding the application of activity-based costing in various types of industries. Apart from that, practically, organizations or companies can use it as a consideration in determining their policies, especially those related to organizational activities and the implementation of activity-based costing. Novelty: This research discusses in depth research trends in activity-based costing, especially topics related to technological advances and corporate awareness of the environment and sustainability, this will have an impact on ABC research. Not many studies have discussed this topic using bibliometric analysis methods.

Context. Some giant radio galaxies selected at X-rays with active galactic nuclei (AGN) show signs of a restarted nuclear activity (old lobes plus a nuclear young radio source probed by giga-hertz peaked spectra). The study of these sources gives us insights into the AGN activity history. More specifically, the kinematics and properties of the outflows can be used as a tool to describe the activity of the source. Aims. One object in this peculiar class is Mrk 1498, a giant low-frequency double radio source that shows extended emission in [O III]. This emission is likely related to the history of the nuclear activity of the galaxy. We investigate whether this bubble-like emission might trace an outflow from either present or past AGN activity. Methods. Using a medium-resolution spectroscopy (R ∼ 10 000) available with MEGARA/GTC, we derived kinematics and fluxes of the ionised gas from modelling the [O III] and Hβ features. We identified three kinematic components and mapped their kinematics and flux. Results. All the components show an overall blue to red velocity pattern, with similar peak-to-peak velocities but a different velocity dispersion. At a galactocentric distance of ∼2.3 kpc, we found a blob with a velocity up to 100 km s−1, and a high velocity dispersion (∼170 km s−1) that is spatially coincident with the direction of the radio jet. The observed [O III]/Hβ line ratio indicates possible ionisation from AGN or shocks nearly everywhere. The clumpy structure visibile in HST images at kiloparsec scales show the lowest values of log[O III]/Hβ (< 1), which is likely not related to the photoionisation by the AGN. Conclusions. Taking optical and radio activity into account, we propose a scenario of two different ionised gas features over the radio AGN lifecycle of Mrk 1498. The radio emission suggests at least two main radio activity episodes: an old episode at megaparsec scales (formed during a time span of ∼100 Myr), and a new episode from the core (> 2000 yr ago). At optical wavelengths, we observe clumps and a blob that are likely associated with fossil outflow. The latter is likely powered by past episodes of the flickering AGN activity that may have occurred between the two main radio phases. [ABSTRACT FROM AUTHOR]

Background: Quebec's healthcare system faces significant challenges due to labour shortage, particularly in long-term care facilities (CHSLDs). The aging population and increasing demand for services compound this issue. Teleconsultation presents a promising solution to mitigate labour shortage, especially in small CHSLDs outside urban centers. This study aims to evaluate the cost and cost savings associated with teleconsultation in CHSLDs, utilizing the Time-Driven Activity-Based Costing (TDABC) model within the framework of Value-Based Healthcare (VBHC). Methods: This study focuses on CHSLDs with fewer than 50 beds in remote regions of Quebec, where teleconsultation for nighttime nursing care was implemented. Time and cost data were collected from three CHSLDs over varying periods. The TDABC model, aligned with VBHC principles, was applied through five steps, including process mapping, estimating activity times, calculating resource costs, and determining total costs. Results: Teleconsultation increased the cost per minute for nursing care compared to traditional care, attributed to additional tasks during remote consultations and potential technical challenges. However, cost savings were realized due to reduced need for onsite nursing staff during non-eventful nights. Overall, substantial savings were observed over the project duration, aligning with VBHC's focus on delivering high-value healthcare. Conclusions: This study contributes both theoretically and practically by demonstrating the application of TDABC within the VBHC framework in CHSLDs. The findings support the cost savings from the use of teleconsultation in small CHSLDs. Further research should explore the long-term sustainability and scalability of teleconsultation across different CHSLD sizes and settings within the VBHC context to ensure high-value healthcare delivery. [ABSTRACT FROM AUTHOR]

The article discusses Eric Weiskott's theory that lost prose copies of Langland's poem Piers Plowman existed based on mislineation in manuscripts. Weiskott's argument is tentative and relies on the belief that scribes worked with prose exemplars, but the evidence is inconclusive. The article critiques Weiskott's claims by examining specific instances of mislineation in manuscripts and argues that the evidence does not support the existence of lost prose copies. The article concludes that the traditional approach taken by editors is more supported by the evidence presented in the manuscripts. [Extracted from the article]

Elective lumbar fusions have received criticism for inappropriate utilization. Here, we use a novel Operative Value Index (OVI) to assess whether "indicated," evidence-based lumbar fusions are associated with increased value (outcomes per dollar spent). This study is a retrospective analysis of a prospective observational cohort of 294 patients undergoing elective lumbar fusions at a single large academic institution. All patients were preoperatively evaluated by a panel of neurosurgeons for concordance with evidence-based medicine (EBM), determined through guidelines from the North American Spine Society. Oswestry Disability Index (ODI) scores were collected for all patients both preoperatively and at 6-months postoperatively. Time-driven activity-based costing was employed to determine both direct and indirect intraoperative costs. The OVI was defined as the percent improvement in ODI per $1000 spent intraoperatively. Generalized linear mixed model regression, adjusting for confounders, was performed to assess whether EBM-concordant surgeries were associated with higher OVI. Of 294 elective lumbar fusions, 92.9% (n = 273) were EBM-concordant. The average total cost of an EBM-concordant lumbar fusion was $17,932 (supplies: $13,020; personnel: $4314), compared to $20,616 (supplies: $15,467; personnel: $4758) for an EBM-discordant fusion. Average OVI was 2.27 for a concordant fusion, compared to 0.11 for a discordant fusion. Generalized linear mixed model analysis revealed that EBM-concordant cases were associated with significantly higher OVI (β-coefficient 2.0, P < 0.001). EBM-concordant fusions were associated with 2% greater improvement in ODI scores from baseline for every $1000 spent intraoperatively. Systematic methods for increasing guideline adherence for lumbar fusions could therefore improve value at scale. [ABSTRACT FROM AUTHOR]

As value-based health care arrangements gain traction in spine care, understanding the true cost of care becomes critical. Historically, inaccurate cost proxies have been used, including negotiated reimbursement rates or list prices. However, time-driven activity-based costing (TDABC) allows for a more accurate cost assessment, including a better understanding of the primary drivers of cost in 1-level lumbar fusion. To determine the variation of total hospital cost, differences in characteristics between high-cost and nonhigh-cost patients, and to identify the primary drivers of total hospital cost in a sample of patients undergoing 1-level lumbar fusion. Retrospective, multicenter (one academic medical center, one community-based hospital), observational study. A total of 383 patients undergoing elective 1-level lumbar fusion for degenerative spine conditions between November 2, 2021 and December 2, 2022. Total hospital cost of care (normalized); preoperative, intraoperative, and postoperative cost of care (normalized); ratio of most to least expensive 1-level lumbar fusion. Patients undergoing a 1-level lumbar fusion between November 2, 2021 and December 2, 2022 were identified at two hospitals (one quaternary referral academic medical center and one community-based hospital) within our health system. TDABC was used to calculate total hospital cost, which was also broken up into: pre-, intra-, and postoperative timeframes. Operating surgeon and patient characteristics were also collected and compared between high- and nonhigh-cost patients. The correlation of surgical time and cost was determined. Multivariable linear regression was used to determine factors associated with total hospital cost. The most expensive 1-level lumbar fusion was 6.8x more expensive than the least expensive 1-level lumbar fusion, with the intraoperative period accounting for 88% of total cost. On average. the implant cost accounted for 30% of the total, but across the patient sample, the implant cost accounted for a range of 6% to 44% of the total cost. High-cost patients were younger (55 years [SD: 13 years] vs 63 years [SD: 13 years], p=.0002), more likely to have commercial health insurance (24 out of 38 (63%) vs 181 out of 345 (52%), p=.003). There was a poor correlation between time of surgery (ie, incision to close) and total overall cost (ρ:.26, p<.0001). Increase age (RC: -0.003 [95% CI: -0.006 to -0.000007], p=.049) was associated with decreased cost. Surgery by certain surgeons was associated with decreased total cost when accounting for other factors (p<.05). A large variation exists in the total hospital cost for patients undergoing 1-level lumbar fusion, which is primarily driven by surgeon-level decisions and preferences (eg, implant and technology use). Also, being a "fast" surgeon intraoperatively does not mean your total cost is meaningfully lower. As efforts continue to optimize patient value through ensuring appropriate clinical outcomes while also reducing cost, spine surgeons must use this knowledge to lead, or at least be active participants in, any discussions that could impact patient care. [ABSTRACT FROM AUTHOR]

We contrast sentiment derived from social and news media to investigate its impact across 14 international markets. We find that heightened media sentiment during nontrading periods significantly affects the next day's opening returns even after accounting for the previous‐day activity. Markedly, only the US market exhibits strong reactions to social media, whereas other markets are more responsive to the news. We find that most variability in overnight returns is explained by sentiment aggregated 3 h before markets open. Our findings suggest that the overnight sentiment does not simply subsume previous‐day market activity but contains additional information that helps improve predictability in return forecasting models. [ABSTRACT FROM AUTHOR]

This study advocates for the adoption of activity-based costing systems by mechanical industrial enterprises in state of Constantine, while also identifying obstacles to their implementation. Employing a descriptive analytical approach, the research distributed 40 questionnaires among these enterprises, with 35 deemed valid for analysis. Data processing was conducted using the (SPSS-25). Results revealed that many enterprises still rely on traditional costing methods due to unfamiliarity with activity-based costing, with various factors impeding its adoption. This highlights the need for greater awareness and support for transitioning to activity-based costing systems in the mechanical sector. [ABSTRACT FROM AUTHOR]

Sustainable competitive advantage, a cornerstone of strategic management, encompasses a business's enduring capability to maintain long-term financial superiority over its competitors. The business should optimize its operations by reducing costs and improving efficiency to attain a sustainable competitive advantage. In the present study, the Activity-Based Costing (ABC) system was implemented to calculate the unit costs of a hotel operating in Turkey, and the expenses were allocated to the overnight costs using the Full-Consistency Method (FUCOM) technique. FUCOM is designed to determine room costs in a hotel business accurately. Expert evaluations were simulated to interpret the results statistically. Also, the Best–worst method (BWM) is used to compare the results. The results of this study hold significant implications for decision-makers, implementers, stakeholders, and theoretical contributions to hotel operations. The proposed model will enable hotels to identify room costs and realistically achieve a sustainable competitive edge. The proposed system is also suitable for implementation by other enterprises operating in the service sector. [ABSTRACT FROM AUTHOR]

Researchers studying local governance, especially alternative service delivery arrangements, have long relied on the ICMA ASD survey to examine the scope and nature of service provision and production at the local level. Building upon Lamothe et al. (Public Administration Review, 2018, 78: 613) findings that raise questions concerning the accuracy of the ASD survey and resulting misconceptions about service provision, this paper refines how provision can be conceptualized and measured to promote a better understanding of local governance. Utilizing a unique survey design that incorporates, but also extends the ASD format, we demonstrate that service provision is multifaceted, and jurisdictions participate in varying degrees of provision activities based on the sector of the producing entity. Our findings highlight the importance of properly accounting for provision activities and call into question the efficacy of the conventional contracting framework as the primary theoretical underpinning of most studies of local service delivery arrangements. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is a global health problem, and sentinel lymph node biopsy (SLNB) is the standard procedure for early-stage breast cancer. Technetium-99 (TC-99), alone or combined with blue dye (BD) are conventional tracers for SLNB, but they have safety, availability, and cost limitations. Indocyanine green (ICG) is an alternative tracer that has been gaining acceptance among healthcare professionals. This study aimed at assessing the clinical and economic value of ICG in hospital settings, using the health technology assessment (HTA) framework. Methods: We conducted a comprehensive evaluation of ICG for SLNB, based on literature sources and data collected from two Italian hospitals that switched from TC-99 to ICG. We analyzed ICG's technical attributes through technology documentation and relevant databases. We performed a systematic literature review of 36 studies to assess the clinical effectiveness and safety of ICG. We obtained organizational insights from clinicians and the clinical engineer involved in the study. We applied Time-Driven Activity-Based Costing (TDABC) and Budget Impact Analysis (BIA) to estimate the economic impact of ICG. The ethical, legal, and social implications of ICG were considered through clinicians' inputs and technology documentation. Results: Our results showed that ICG had equivalent or superior clinical effectiveness compared to TC-99 and BD, with minimal adverse events. ICG simplified the surgical pathways, by streamlining procedures, reducing waiting times, and increasing flexibility in scheduling surgeries. Moreover, the TDABC analysis showed significant cost reductions by avoiding the need for pre-operative lymphoscintigraphy and hospitalization, with average savings per single care pathway of around 18% for ICG compared to TC-99. Finally, ICG improved patient experience, and proved regulatory compliance. Conclusions: This study provided strong evidence for ICG's clinical and economic value for SLNB in breast cancer. It ascertained ICG as a valuable alternative to conventional tracers, ensuring clinical effectiveness along with economic and organizational benefits. [ABSTRACT FROM AUTHOR]

Background: Despite growing interest in delivering high-value orthopaedic care, the costs associated with hip arthroscopy remain poorly understood. By employing time-driven activity-based costing (TDABC), we aimed to characterize the cost composition of hip arthroscopy for labral pathological conditions and to identify factors that drive variation in cost. Methods: Using TDABC, we measured the costs of 890 outpatient hip arthroscopy procedures for labral pathological conditions across 5 surgeons at 4 surgery centers from 2015 to 2022. All patients were ≥18 years old and were treated by surgeons who each performed ≥20 surgeries during the study period. Costs were normalized to protect the confidentiality of internal hospital cost data. Descriptive analyses and multivariable linear regression were performed to identify factors underlying cost variation. Results: The study sample consisted of 515 women (57.9%) and 375 men (42.1%), with a mean age (and standard deviation) of 37.1 ± 12.7 years. Most of the procedures were performed in patients who were White (90.6%) or not Hispanic (93.4%). The normalized total cost of hip arthroscopy per procedure ranged from 43.4 to 203.7 (mean, 100 ± 24.2). Of the 3 phases of the care cycle, the intraoperative phase was identified as the largest generator of cost (>90%). On average, supply costs accounted for 48.8% of total costs, whereas labor costs accounted for 51.2%. A 2.5-fold variation between the 10th and 90th percentiles for total cost was attributed to supplies, which was greater than the 1.8-fold variation attributed to labor. Variation in total costs was most effectively explained by the labral management method (partial R² = 0.332), operating surgeon (partial R² = 0.326), osteoplasty type (partial R² = 0.087), and surgery center (partial R² = 0.086). Male gender (p < 0.001) and younger age (p = 0.032) were also associated with significantly increased costs. Finally, data trends revealed a shift toward labral preservation techniques over debridement during the study period (with the rate of such techniques increasing from 77.8% to 93.2%; Ptrend = 0.0039) and a strong correlation between later operative year and increased supply costs, labor costs, and operative time (p < 0.001 for each). Conclusions: By applying TDABC to outpatient hip arthroscopy, we identified wide patient-to-patient cost variation that was most effectively explained by the method of labral management, the operating surgeon, the osteoplasty type, and the surgery center. Given current procedural coding trends, declining reimbursements, and rising health-care costs, these insights may enable stakeholders to design bundled payment structures that better align reimbursements with costs. [ABSTRACT FROM AUTHOR]

Background: Patients with Hemophilia are continually monitored at treatment centers to avoid and control bleeding episodes. This study estimated the direct and indirect costs per patient with hemophilia A in Brazil and evaluated the cost variability across different age groups. Methods: A prospective observational research was conducted with retrospective data collection of patients assisted at three referral blood centers in Brazil. Time-driven Activity-based Costing method was used to analyze direct costs, while indirect costs were estimated based on interviews with family and caregivers. Cost per patient was analyzed according to age categories, stratified into 3 groups (0–11;12–18 or older than 19 years old). The non-parametric Mann-Whitney test was used to confirm the differences in costs across groups. Results: Data from 140 hemophilia A patients were analyzed; 53 were 0–11 years, 29 were 12–18 years, and the remaining were older than 19 years. The median cost per patient per year was R$450,831 (IQR R$219,842; R$785,149; $174,566), being possible to confirm age as a cost driver: older patients had higher costs than younger's (p = 0.001; median cost: 0–11 yrs R$299,320; 12–18 yrs R$521,936; ≥19 yrs R$718,969). Conclusion: This study is innovative in providing cost information for hemophilia A using a microcosting technique. The variation in costs across patient age groups can sustain more accurate health policies driven to increase access to cutting-edge technologies and reduce the burden of the disease. Highlights: This study provides cost data, measured with microcosting methodology, for Hemophilia A patients in an LMIC, demonstrating how costs are sensible to the patient's age. The results showed the importance of considering patients' clinical and demographic characteristics to establish adequate reimbursement policies driven to reduce the health impact of the disease, due to the cost variability observed. Brazil has one of the biggest hemophilia A populations, and based on the cost measured, the financial burden associated with this condition is estimated to be R$ 5,19 billion yearly. [ABSTRACT FROM AUTHOR]

Pituitary adenomas (PAs) are the third most common brain tumors in adults right after meningiomas and gliomas. Taking into account their hormonal activity in vivo, they can be divided in functioning PAs, which secrete hormones, and nonfunctioning pituitary adenomas (NFPAs), which are not associated with increased hormone secretion. We present the case of a man diagnosed with pituitary apoplexy. A transsphenoidal surgery was performed with subtotal removal of the mass. Pituitary hormones were measured before and after the procedure on several occasions, showing always normal PRL values, so he was diagnosed with a clinically NFPA. Two years later, the patient noticed a visual deficit. A new magnetic resonance imaging study was performed, showing adenomatous recurrence, and the patient underwent a new surgery. After this, hormonal evaluation revealed high levels of PRL on several occasions. After treatment with cabergoline was started, PRL levels normalized, the visual deficit improved, and there was a slight adenoma reduction. This case report represents an exception to the paradigm that in the presence of a macroadenoma and normal PRL levels (avoiding the "hook effect"), a prolactinoma can be discarded. Moreover, it stresses the importance of comprehensive, regular, and lifelong surveillance of patients with NFPAs and the close monitoring of serum PRL. [ABSTRACT FROM AUTHOR]

We examine the extent to which basic factors, such as the structure, complexity, and usefulness of a cost system, affect the design of cost systems and the resulting satisfaction and help companies make the right decisions. Moreover, we examine the relationship between the structure and complexity of cost systems with (a) a company's demographic data, such as the volume of its activities, the number of years it has been operating, its sector, its size, and the gender, age, level of training, and position of its employees; and (b) information concerning production and competition, such as the number of products that a company produces, the number of a company's production lines, the level of competition, and the extent to which competition affects a company's pricing policy. Empirical research was conducted via a questionnaire in which a sample of 114 industrial companies in Greece took part. The findings revealed that the structure and the usefulness of a cost system, but not its complexity, significantly affect the satisfaction users get from the system when they are called to make fast and correct decisions. The results point out a positive correlation between the satisfaction a user gets from a cost system and the range of information (R), the calculation of deviations (CS), the provision of accurate information (CS), the quality of information (CS), the number of cost pools (C), the number of allocation bases (C), and the cost information (U). Companies that produce more goods and have a complex production process have cost systems that not only have a more detailed structure and provide more detailed information with the calculation of deviations as well as accurate information but also have more cost pools and cost allocation bases. The more competition affects a company's pricing policy, the more a company seeks systems that categorize costs based on behavior (structure) and more cost allocation bases (complexity). The larger a company is, with a long (>20 years) and international presence, the higher the probability a company will have a system with a more detailed cost information structure. [ABSTRACT FROM AUTHOR]

The ecosystem service (ES) is essential for residents' health and well-being. The ecosystem service value (ESV) is one of the measures to scientifically quantify the wealth of ESs. However, climate and human activities intensely affect the sustainability of ESs. Therefore, knowing the relative and combined effects of climate and human activities on ESs and ESV can be crucial. This study selects the Yangtze River Economic Belt (YREB) as the study area to detect how climate and human activities affected the ES and ESV changes during 2001–2020, including net primary productivity, water yield, soil retention, water purification, and integrated ESV. The results show that the southern YREB has relatively higher ESs than the northern YREB, except for the NDR-P, which is mainly located in the urban agglomeration area. The general ranking for the ESV of different provinces in the YREB is sequenced from higher to lower as Sichuan, Yunnan, Hunan, Jiangxi, Guizhou, Hubei, Zhejiang, Anhui, Jiangsu, Chongqing, and Shanghai. Specifically, the ESV of Sichuan is the highest at about 972 billion yuan (133.57 billion USD), while the lowest ESV has been discovered in Shanghai at approximately 0.25 billion yuan (0.03 billion USD). It can be noticed that the regions where climate is the major influencing factor for ESs are concentrated upstream of the YREB, and human activities mainly influence ESs in highly urbanized areas. Furthermore, climate and human activities account for the highest proportion (86%) of synergistic effects for ESV in Yunnan. In contrast, Jiangsu, Zhejiang, and Shanghai accounted for the lowest proportions, at 18%, 26%, and 31%, respectively. This study may provide crucial insights into how ESs and ESV in the YREB have changed during the study period to inform policymakers, drawing more attention to the inhibitory and synergistic effects arising from the interaction between climate and human activities, to make more reliable decisions on adapting to climate crises in the future. [ABSTRACT FROM AUTHOR]

Background: This study is a cost-effectiveness study of two implementation strategies designed to train therapists in college and university counseling centers to deliver interpersonal psychotherapy. Costs of implementing a train-the-trainer (TTT) strategy versus an expert consultation strategy were estimated, and their relative effects upon therapist outcomes were calculated and compared. Methods: Twenty four counseling centers were recruited across the United States. These centers were randomized to either a TTT (experimental) condition, in which an in-house therapist trained other center therapists, or an expert consultation condition, in which center therapists participated in a workshop and received 12 months of ongoing supervision. The main outcome was therapist fidelity (adherence and competence) to interpersonal psychotherapy, assessed via audio recordings of therapy sessions, and analyzed using linear mixed models. Costs of each condition were quantified using time-driven activity-based costing methods, and involved a costing survey administered to center directors, follow up interviews and validation checks, and comparison of time tracking logs of trainers in the expert condition. Mean costs to produce one therapist were obtained for each condition. The costs to produce equivalent improvements in therapist-level outcomes were then compared between the two conditions. Results: Mean cost incurred by counseling centers to train one therapist using the TTT strategy was $3,407 (median = $3,077); mean cost to produce one trained therapist in the control condition was $2,055 (median = $1,932). Therapists in the TTT condition, on average, demonstrated a 0.043 higher adherence score compared to therapists in the control condition; however, this difference was not statistically significant. For the competence outcome, effect size for therapists in the TTT condition was in the large range (1.16; 95% CI: 0.85–1.46; p <.001), and therapists in this condition, on average, demonstrated a 0.073 higher competence score compared to those in the expert consultation condition (95% CI, 0.008–0.14; p =.03). Counseling centers that used the TTT model incurred $353 less in training costs to produce equivalent improvements in therapist competence. Conclusions: Despite its higher short run costs, the TTT implementation strategy produces greater increases in therapist competence when compared to expert consultation. Expanding resources to support this platform for service delivery can be an effective way to enhance the mental health care of young people seeking care in college and university counseling centers. Trial registration: ClinicalTrials.gov Identifier: NCT02079142. [ABSTRACT FROM AUTHOR]

Background: Comprehensive sexual reproductive health (SRH) programs for female sex workers (FSW) offering clinical, behavioural, and structural interventions have contributed to declining rates of HIV in this population. However, data on costs and cost drivers is needed to support programs and their donors to better allocate resources, make an investment case for continued funding, and to identify areas of improvement in program design and implementation. We aimed to estimate the annual per-FSW costs of comprehensive services for a standalone FSW program in Kenya. Methods: We implemented a top–bottom and activity-based costing study of comprehensive FSW services at two drop-in centres (DICs), Mtwapa and Kilifi town, in Kilifi County, Kenya. Service costs were obtained from routinely collected patient data during FSW scheduled and unscheduled visits using Kenyan Ministry of Health records. Costing data were from the program and organization's expenditure reports, cross checked against bank documents and supported by information from in-depth interviews. Data were collected retrospectively for the fiscal year 2019. We obtained approval from the AMREF Research Ethics Committee (AMREF-ESRC P862/2020). Results: In 2019, the unit cost of comprehensive services was 105.93 USD per FSW per year, roughly equivalent to 10,593 Kenya shillings. Costs were higher at Mtwapa DICs compared to Kilifi town DIC; 121.90 USD and 89.90 USD respectively. HIV counselling and testing cost 63.90 USD per person, PrEP was 34.20 USD and family planning was 9.93 USD. Of the total costs, staff salaries accounted for about 60%. Adjusted for inflation, costs in 2024 would be approximately 146.60. Conclusion: Programs should strive to maximize the number of FSW served to benefit from economies of scale. Given that personnel costs contribute most to the unit costs, programs should consider alternative designs which reduce personnel and other costs. [ABSTRACT FROM AUTHOR]

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Ankle fractures are one of the most resource-consuming traumatic orthopedic injuries. Few studies have successfully evaluated the episode-of-care costs (EOCC) of common traumatic orthopedic injuries. The objective of this study was to determine the EOCC associated with the surgical management of ankle fractures. A retrospective cohort study of 105 consecutive patients who underwent open reduction internal fixation of an isolated ankle fracture at a Canadian Level-1 trauma center was conducted. Episode-of-care costs were generated using an activity-based costing framework. The median global episode-of-care cost for ankle fracture surgeries performed at the studied institution was $3,487 CAD [IQR 880] ($2,685 USD [IQR 616]). Patients aged 60 to 90 years had a significantly higher median EOCC than younger patients (p =.01). Supination-adduction injuries had a significantly higher median EOCC than other injury patterns (p =.01). The median EOCC for patients who underwent surgery within 10 days of their injury ($3,347 CAD [582], $2,577 USD [448]) was significantly lower than the cost for patients who had their surgery delayed 10 days or more after the injury ($3,634 CAD [776], $2,798 USD [598]) (p =.03). Patient sex, anesthesia type, ASA score and surgeon's fellowship training did not affect the EOCC. This study provides valuable data on predictors of EOCC in the surgical management of ankle fractures. Delaying simple ankle fracture cases due to operating time constraints can increase the total cost and burden of these fractures on the healthcare system. In addition, this study provides a framework for future episode-of-care cost analysis studies in orthopedic surgery. [ABSTRACT FROM AUTHOR]

Introduction: Meeting the needs of shareholders and investors, generating profit and income, and covering current expenses are the primary objectives of any economic entity. Banks and financial institutions are no exception, and calculating and understanding costs is one of their most critical activities. In today's competitive environment, organizations must adopt strategies that enhance the quality of services and products while reducing their costs. To achieve this, having tools for analyzing related costs and formulating cost policies for services and products is essential. Companies that previously used traditional costing systems have had to transition to newer, more dynamic, and flexible costing systems that account for various costs, including products, activities, distribution channels, and customers, reflecting the complexity of modern business and production processes. This article presents a model for calculating the cost of banking services using activitybased costing. Methods: The research described in this article is developmental-applied. Given the various factors affecting costs and their nonlinear and cyclical effects, which render banks as complex systems, the methodology of system dynamics was used for modeling. This research is descriptive in terms of data collection methods, which included library studies reviewing sources and references on activity-based costing and systems dynamics principles, simulations concerning the cost of banking services using systems dynamics, and other sources such as books, magazines, articles, and theses from reputable libraries, information search centers, and credible websites. Results and discussion: In this study, detailed models for two products, mudarabah and deposits, were developed. Cause-and-effect diagrams and their rates and statuses were drawn, and after testing the models, proposed scenarios were designed and compared. Four scenarios were suggested to improve system behavior: improving productivity, adjusting human resources, re-engineering business processes, and automating processes. To select the best policy--one that achieves the most significant cost reduction over a similar period--all policies were compared. The study's findings indicate that the policy of mechanization and process re-engineering is the most effective. Therefore, the bank's general policy for reducing product costs can be a combination of reengineering and mechanizing processes. Conclusions: Considering the dynamic business environment and banks as complex systems where many variables influence each other, the systems dynamics approach was employed to model the cost of banking services. The simulation results show that a combination of process re-engineering and automation can serve as an effective policy for reducing the cost of banking services. [ABSTRACT FROM AUTHOR]

Purpose: Blockchain's potential is so significant that business activities across all industries can be drastically altered. Furthermore, the characteristics of blockchain appear to be well-suited to accounting requirements. However, accounting professionals' attitude and intention toward blockchain adoption are not clear, particularly in India. Thus, this study aims to investigate and evaluate accountants' intention to adopt blockchain technology in accounting activities. Design/methodology/approach: This study examined and assessed accountants' intention to use blockchain in accounting. To effectively measure usage intention, this study extended the unified theory of acceptance and use of technology (UTAUT) model by including context-specific constructs. To empirically test and validate the proposed model, data were collected from "369" professional accountants in India. Findings: The findings revealed that facilitating conditions, performance expectancy and initial trust had a significant impact on adoption. Furthermore, the regulatory framework materially moderated the association between usage intention and its predictors. Originality/value: These findings provide new empirical evidence about the impact of different predictors of usage intention by extending the UTAUT model. Relevant stakeholders can refer to this pioneering study to increase the adoption of blockchain as an efficient and trustworthy system among professional accountants, particularly in developing countries such as India. [ABSTRACT FROM AUTHOR]

Ice-nucleating macromolecules (INMs) produced by plant pollen can nucleate ice at warm temperatures and may play an important role in weather- and climate-relevant cloud glaciation. INMs have also proved useful for mammalian cell and tissue model cryopreservation. The high ice nucleation (IN) activity of some INMs indicates an underlying biological function, either freezing tolerance or bioprecipitation-mediated dispersal. Here, using the largest study of pollen ice nucleation to date, we show that phylogenetic proximity, spermatophyte subdivision, primary growth biome, pollination season, primary pollination method, desiccation tolerance and native growth elevation do not account for the IN activity of INMs released from different plant species' pollen. The results suggest that these macromolecules are produced by plants for a purpose unrelated to ice nucleation and have an incidental ability to nucleate ice. This ability may have been adapted by some species for specific biological purposes, producing exceptional ice nucleators. Pollen INMs may be more active, widespread in nature, and diverse than previously thought. [ABSTRACT FROM AUTHOR]

Purpose: This study examines the effect of cost management practices on the profitability of listed manufacturing companies in Sri Lanka, focusing on the application of Activity-Based Costing (ABC) during the COVID-19 pandemic. Method: The study employs quantitative methods to analyze secondary data from the annual reports of 70 listed manufacturing companies between 2019 and 2023. Data analysis was conducted using SPSS software, including tests for correlation, multiple regression analysis, data stationarity, autocorrelation, and multicollinearity. Result: The findings reveal a significant negative correlation between direct material costs and profitability, suggesting that effective management of material costs through ABC enhances financial performance. Similarly, direct labor costs also show a significant negative relationship with profitability, emphasizing ABC's role in optimizing labor costs to increase profits. Factory overhead costs exhibit a significant negative correlation with profitability, highlighting ABC's effectiveness in reducing non-productive overheads. In contrast, administrative expenses have an insignificant impact on profitability, indicating the limited efficacy of ABC in managing these costs. Overall, the results affirm ABC's utility in controlling production-related costs but suggest the need for alternative strategies for managing administrative expenses. Practical Implications for Economic Growth and Development: The study emphasizes the importance of efficient cost reduction methods, which can improve firm productivity, increase profitability, and support stability and economic recovery in the post-pandemic period.

Introduction: Meeting the needs of shareholders and investors, generating profit and income, and covering current expenses are the primary objectives of any economic entity. Banks and financial institutions are no exception, and calculating and understanding costs is one of their most critical activities. In today's competitive environment, organizations must adopt strategies that enhance the quality of services and products while reducing their costs. To achieve this, having tools for analyzing related costs and formulating cost policies for services and products is essential. Companies that previously used traditional costing systems have had to transition to newer, more dynamic, and flexible costing systems that account for various costs, including products, activities, distribution channels, and customers, reflecting the complexity of modern business and production processes. This article presents a model for calculating the cost of banking services using activity-based costing. Methods: The research described in this article is developmental-applied. Given the various factors affecting costs and their nonlinear and cyclical effects, which render banks as complex systems, the methodology of system dynamics was used for modeling. This research is descriptive in terms of data collection methods, which included library studies reviewing sources and references on activity-based costing and systems dynamics principles, simulations concerning the cost of banking services using systems dynamics, and other sources such as books, magazines, articles, and theses from reputable libraries, information search centers, and credible websites. Results and discussion: In this study, detailed models for two products, mudarabah and deposits, were developed. Cause-and-effect diagrams and their rates and statuses were drawn, and after testing the models, proposed scenarios were designed and compared. Four scenarios were suggested to improve system behavior: improving productivity, adjusting human resources, re-engineering business processes, and automating processes. To select the best policy—one that achieves the most significant cost reduction over a similar period—all policies were compared. The study's findings indicate that the policy of mechanization and process re-engineering is the most effective. Therefore, the bank's general policy for reducing product costs can be a combination of re-engineering and mechanizing processes. Conclusions: Considering the dynamic business environment and banks as complex systems where many variables influence each other, the systems dynamics approach was employed to model the cost of banking services. The simulation results show that a combination of process re-engineering and automation can serve as an effective policy for reducing the cost of banking services.

Abstract Background Estimating program costs when planning community-based mental health programs can be burdensome. Our aim was to retrospectively document the cost for the first year of planning and implementing Healthy Minds Healthy Communities (HMHC), a mental health promotion and prevention multi-level intervention initiative. This Program is among the first to use the Community Initiated Care (CIC) model in the US and is aimed at building community resilience and the capacity for communities to provide mental health support, particularly among those disproportionately impacted by COVID-19. Our objective is to share our methods for costing a program targeting 10 zip codes that are ethnically and linguistically diverse and provide an example for estimating the cost of a mental health prevention and promotion programs consisting of multiple evidence-based interventions. Methods We used a semi-structured interview process to collect cost data through the first year of program planning, start-up and initial implementation from key staff. We calculated costs for each activity, grouped them by major project categories, and identified the cost drivers of each category. We further validated cost estimates through extensive literature review. The cost analysis was done from the provider’s perspective, which included the implementing agency and its community partners. We delineated costs that were in-kind contributions to the program by other agency, and community partners. Sensitivity analyses were conducted to estimate uncertainty around parameters. Results For the first year of the development and implementation of the program, (funded through program and in-kind) is estimated at $1,382,669 (2022 US$). The costs for the three main activity domains for this project are: project management $135,822, community engagement $364,216 and design and execution $756,934. Overall, the cost drivers for the first year of this intervention were: hiring and onboarding staff, in-person community building/learning sessions, communications and marketing, and intervention delivery. Conclusion Implementation of community-based mental health promotion and prevention programs, when utilizing a participatory approach, requires a significant amount of upfront investment in program planning and development. A large proportion of this investment tends to be human capital input. Developing partnerships is a successful strategy for defraying costs.

Objective: This study evaluated the influence of technology on accurately measuring costs using time-driven activity-based costing (TDABC) in healthcare provider organizations by identifying the most recent scientific evidence of how it contributed to increasing the value of surgical care. Methods: This is a literature-based analysis that mainly used two data sources: first, the most recent systematic reviews that specifically evaluated TDABC studies in the surgical field and, second, all articles that mentioned the use of CareMeasurement (CM) software to implement TDABC, which started to be published after the publication of the systematic review. The articles from the systematic review were grouped as manually performed TDABC, while those using CM were grouped as technology-based studies of TDABC implementations. The analyses focused on evaluating the impact of using technology to apply TDABC. A general description was followed by three levels of information extraction: the number of cases included, the number of articles published per year, and the contributions of TDABC to achieve cost savings and other improvements. Results: Fourteen studies using real-world patient-level data to evaluate costs comprised the manual group of studies. Thirteen studies that reported the use of CM comprised the technology-based group of articles. In the manual studies, the average number of cases included per study was 160, while in the technologybased studies, the average number of cases included was 4,767. Technologybased studies, on average, have a more comprehensive impact than manual ones in providing accurate cost information from larger samples. Conclusion: TDABC studies supported by technologies such as CM register more cases, identify cost-saving opportunities, and are frequently used to support reimbursement strategies based on value. The findings suggest that using TDABC with the support of technology can increase healthcare value. [ABSTRACT FROM AUTHOR]

To assess the outcomes, total healthcare utilization, and cost savings for same-day discharge (SDD) vs inpatient robotic-assisted partial nephrectomy (RAPN) and robotic-assisted radical nephrectomy (RARN). We compared 146 RAPNs and 65 RARNs consecutively performed as SDD (RAPN = 21, RARN = 9) vs inpatient (RAPN = 125, RARN = 56) from April 2015 to May 2023 at two academic medical centers. We collected baseline demographics, perioperative characteristics, and 30-day complications. We applied the Time-Driven Activity-Based Costing analysis to compare total costs of RAPN and PARN throughout the cycle of care, including inpatient vs SDD. Baseline demographics and comorbidities were similar between patients undergoing inpatient vs SDD RAPN and RARN. One Clavien-Dindo grade II complication (3.3%) requiring readmission due to wound infection for antibiotics occurred after SDD RAPN; no complications occurred after SDD RARN. Two unscheduled office or emergency department visits (6.7%) occurred after SDD RAPN for surgical-site infection and urinary retention. SDD vs inpatient RAPN and RARN demonstrated a $3091 (18%) and $4003 (25%) overall cost reduction, respectively. SDD RAPN and RARN result in cost savings of 18%-25% without a difference in complications, and thereby improves value-based care for appropriately selected patients. [ABSTRACT FROM AUTHOR]