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Inspired by the global budget concept in health care, we propose an innovative subsidy scheme in which governments do not commit the subsidy amount in advance but determine it by the end of the subsidy period. The performance of the traditional and proposed subsidy schemes is evaluated in an oligopoly without competition, where each manufacturer decides its product quality and production quantity under the diseconomies of scale in production. Both types of schemes can take into account product quality or not. Our results show that compared to the traditional scheme, the proposed scheme drives manufacturers to reduce production quantity but improves product quality and brings them higher profits. Furthermore, the scheme results in greater social welfare when the subsidy budget is large. Finally, we conduct robustness checking by considering the market competition and absence of the diseconomies of scale, respectively. The result shows that the main findings in the basic model continue to hold, while there are additional findings. In the first scenario, as the market competition intensity increases, our proposed scheme becomes more preferable to the manufacturers and the government. In the second scenario, subsidy schemes that take product quality into account are never preferable. [ABSTRACT FROM AUTHOR]

Human-robot collaborative disassembly lines are widely used by remanufacturing companies to disassemble end-of-life (EOL) products. When disassembling large-sized EOL products, each workstation on a disassembly line is generally divided into multiple operating positions, so that different operators can disassemble the same product at their respective positions at the same time, thereby greatly improving efficiency. This paper focuses on a position-constrained human-robot collaborative disassembly planning (PC-HRCDP) problem for the above-mentioned lines, including three subproblems of disassembly sequence planning, disassembly line balancing and robot path planning. A multi-objective mixed integer programming model for PC-HRCDP is developed to solve smallscale instances. Furthermore, a multi-objective multi-fidelity optimisation (MO-MFO) algorithm is proposed to solve large-scale instances. Comprehensive experiments are conducted based on 10 problem instances generated in this study. Experimental results show that the proposed MO-MFO is better than a high-fidelity optimisation algorithm in terms of running time. In addition, benefiting from the strategy of MO-MFO to allocate the limited high-fidelity computational budget to solutions in the two stages of multi-objective optimisation and optimal sampling, MO-MFO is significantly better than the existing representative multi-fidelity optimisation algorithms in terms of the hyper-volume and the inverted generational distance. [ABSTRACT FROM AUTHOR]

We study a production lot-sizing problem inspired by a veterinary pharmaceutical plant in which demands are uncertain. First, we develop a deterministic capacitated lot-sizing model for the production of animal pesticides, performed in three machine-specific stages. Second, we propose a traditional robust optimisation formulation following the popular budget-of-uncertainty approach. Third, we derive a novel fragility-based approach that circumvents well-known issues with traditional robust optimisation approaches, such as the estimation of budgets of uncertainty, the over-conservatism of robust solutions and the sensitivity of solutions to the decision maker's risk attitude. The fragility-based approach is grounded in the idea of minimising violations, over the full uncertainty support, from a user-specified cost target. It avoids the estimation of budgets of uncertainty and produces less conservative solutions via explicit modelling of constraint violation. We demonstrate the effectiveness of our approach on instances built upon real data provided by our industrial partner, a major player in the Brazilian veterinary pharmaceutical sector. The results show that our fragility-based approach reduces average total costs across all instances and maintains greater model stability under different target estimations. It also preserves cost savings when bottlenecks are introduced in production and when inventory costs and capacities are varied. [ABSTRACT FROM AUTHOR]

This paper presents novel models for the Integrated Procurement and Lot-Sizing Problem with multiple customers and backlogging. Since allowing backlog in a traditional cost minimisation model involves dealing with intangible costs of not fulfilling the demand on time, we propose optimising service-levels while keeping the costs minimal using a budget constraint. The motivation of this study emanates from a manufacturing company that assembles commercial and industrial refrigeration equipment, using both purchased materials and in-house products. Instead of considering an aggregate demand, we consider the specific demand from various customers. This allows us to incorporate demand fulfilment decisions into the model in case of stock-outs by deciding which customers will have their orders backlogged. The fill-rate, or β service-level, is considered both globally and for customers and products individually. Computational experiments show that the service-level-driven models improve service when compared to the traditional cost model and also end up enforcing service equity among different customers at the expense of a deterioration in the global fill-rate. [ABSTRACT FROM AUTHOR]

We present the census of H  |$\beta$|  + [ |${\rm O\, {\small III}}$| ] |$4960,5008\rm{\mathring{\rm\,A}}$| emitters at |$6.8\lt z\lt 9.0$| from the JWST FRESCO survey over 124 arcmin |$^2$| in the GOODS-North and GOODS-South fields. Our unbiased spectroscopic search results in 137 spectroscopically confirmed galaxies at |$6.8\lt z\lt 9.0$| with observed [ |${\rm O\, {\small III}}$| ] fluxes |$f_{\rm { [{\rm O\, {\small III}}]}}\gtrsim 1\times 10^{-18}\ \rm {ergs}\ \rm {s}^{-1} \ \rm {cm}^{-2}$|⁠. The rest-frame optical line ratios of the median stacked spectrum (median |$M_{\rm {UV}}=-19.65^{+0.59}_{-1.05}$|⁠) indicate negligible dust attenuation, low metallicity (⁠|$12+\log (\rm {O/H})= 7.2-7.7$|⁠) and a high ionization parameter |$\log _{10}U \simeq -2.5$|⁠. We find a factor |$\times 1.3$| difference in the number density of |$6.8\lt z\lt 9.0$| galaxies between GOODS-South and GOODS-North, which is caused by a single overdensity at |$7.0\lt z\lt 7.2$| in GOODS-North. The bright end of the UV luminosity function of spectroscopically confirmed [ |${\rm O\, {\small III}}$| ] emitters is in good agreement with HST dropout-selected samples. Discrepancies between the observed [ |${\rm O\, {\small III}}$| ] LF, [ |${\rm O\, {\small III}}$| ]/UV ratio, and [ |${\rm O\, {\small III}}$| ] equivalent widths, and that predicted by theoretical models, suggest burstier star-formation histories and/or more heterogeneous metallicity and ionizing conditions in |$z\gt 7$| galaxies. We report a rapid decline of the [ |${\rm O\, {\small III}}$| ] luminosity density at |$z\gtrsim 6\!-\!7$| which cannot be explained by the evolution of the cosmic star-formation rate density. Finally we find that FRESCO detects in only 2h galaxies likely accounting for |$\sim 10-20{{\ \rm per\ cent}}$| of the ionizing budget at |$z=7\!-\!8$| (assuming an escape fraction of |$10{{\ \rm per\ cent}}$|⁠), raising the prospect of directly detecting a significant fraction of the sources of reionization with JWST. [ABSTRACT FROM AUTHOR]

The article is devoted to the analysis of the issues of the legal basis of attracting funds from the State Budget of Ukraine, local budgets and EU funds for the implementation of the «green» transition of the energy sector of the economy and the implementation of projects (programs) in the field of energy efficiency. The article found out that the budget legislation of Ukraine enshrines a number of instruments that make it possible to attract budget funds for the implementation of measures and investment projects in the energy sector, namely: A) for the implementation of state investment projects (programs) and other investment projects in the energy sector the following are carried out: 1) budget expenditures directed to the purpose of state investment in state-owned objects using state capital investments; 2) crediting the budget for the implementation of investment projects implemented through state investment; 3) provision of state or local guarantees for the implementation of investment projects in the field of energy provided with budgetary funds of the relevant budget; B) to provide state financial support to participants in the electricity market, who are entrusted with special duties to ensure an increase in the share of electricity production from alternative energy sources (SE «Guaranteed Buyer»), State Budget expenditures are made; C) for the implementation of «green» transition measures implemented at the expense of the State Budget of Ukraine by the Energy Efficiency Fund, according to the relevant budget programs, in the budget program «State Fund for Decarbonization and Energy Efficient Transformation», programs of the Energy Efficiency Fund; D) to realize, at the expense of State and local budgets, longterm obligations for energy service in accordance with energy service contracts concluded by managers of budget funds to improve the energy efficiency of state and communal property; D) to implement at the expense of EU funds in accordance with the Ukraine Facility the measures provided for in the Plan of Ukraine 2024-2027, in the form of expenditures of the State Budget of Ukraine (Component I), and lending to selected investment projects (Component II), the «visibility» of using which Ukraine has to provide It was noted that the budgetary legislation of Ukraine needs to be supplemented in terms of establishing the legal regime of budgetary investment, which has distinct features from spending and lending, establishing the obligation to ensure the «visibility» of the use of EU funds involved in the relevant budgets, carrying out transactions with them, as well as establishing the concept of «EU funds», as it occurs in the budgetary law of the EU member states. [ABSTRACT FROM AUTHOR]

The ocean serves as a significant contributor of atmospheric Hydrogen (H2) with indirect greenhouse effects. However, uncertainties persist regarding internal production and consumption processes of marine H2, as well as controlling factors. Our study examined the spatial distribution and source‐sink dynamics of marine H2 in the Eastern Indian Ocean. H2 concentrations in surface seawater exhibited a range of 2.95–21.96 nmol L−1. High concentrations of H2 were observed in the anoxic water in the Bay of Bengal. Rates of H2 photo‐production and microbial consumption in surface seawater ranged from 1.80 to 17.78 nmol L−1 h−1 and 1.02–9.18 nmol L−1 h−1, respectively. When considering the entire mixed layer, photo‐production contribute to approximately 31%–43% of the total H2 removal, with cyanobacteria potentially serving as another source in the mixed layer. Compared with the sea‐to‐air exchange, microbial consumption was the primary removal pathway of H2 in seawater. Plain Language Summary: Atmospheric hydrogen (H2) can influence the environment and climate by consuming hydroxyl radicals (OH·) and indirectly raising greenhouse gas concentrations. Although the ocean serves as a significant source of atmospheric H2, the biogeochemical processes governing its presence in seawater remain poorly understood. The Eastern Indian Ocean, characterized by a substantial inflow of freshwater, exerts a distinct impact on the local ecosystem. We conducted a field investigation in the Eastern Indian Ocean to clarify the sources, sinks, and controlling factors of H2, including the Bay of Bengal with relatively higher primary productivity and the Eastern Equatorial Indian Ocean with low primary productivity, respectively. Our study involved the quantitative assessment of H2 photo‐production, microbial consumption, and sea‐to‐air exchange in seawater, along with the calculation of the H2 budget in the mixed layer. This investigation enhances our understanding of H2 cycling processes in seawater and contributes to the assessment of H2 emissions from the ocean and their impact on the atmospheric budget. Key Points: The distribution of H2 was significantly affected by river input in the Eastern Indian OceanPhoto‐production was an important source of H2 in the mixed layerMicrobial consumption was the primary sink for H2 in the mixed layer [ABSTRACT FROM AUTHOR]

The article presents a budget impact analysis comparing the cost and efficiency of digital workflow versus conventional methods for implant-supported overdentures. Results from a study involving 36 edentulous patients showed that the digital approach led to a 14.2% reduction in initial costs, 41.1% decrease in treatment time, and 47.1% fewer treatment sessions. In the Netherlands, the 3D-IOD was found to be more cost-effective than the conventional C-IOD, potentially saving around 50 million euros annually. Overall, the digital workflow was shown to provide high-quality overdentures at lower costs, without compromising general health-related quality of life, benefiting both patients and healthcare systems. [Extracted from the article]

Women are not a demographic minority, but they certainly are a minority in politics. Most legislative bodies across the world are still overwhelmingly male. Female candidates cite lack of resources as one of the main deterrents to run. Using data on candidates encompassing twenty‐eight elections in sixteen countries between 2006 and 2017, we examine the role of electoral institutions, partisanship and candidates’ political profile in mitigating – or aggravating – the gender resource gap. We find that female candidates systematically avail of significantly lower campaign budgets. This is true across different electoral systems and on the left as well as on the right. The gap is larger in size among incumbents. It is also wider in parties that use voluntary quotas and put forward more female candidates. Moreover, the budget composition of male and female candidates varies considerably. Male candidates tend to use higher proportions of their own resources, while female candidates rely on proportionally higher party contributions, that are, however, smaller in size. [ABSTRACT FROM AUTHOR]

Background: The Saudi Food and Drug Authority (SFDA) has approved the subcutaneous (SC) administration of infliximab, presenting a more convenient alternative with reduced outpatient visits and diminished expenses compared to the intravenous (IV) administration. However, the financial implications of this formulation have not been examined from the perspective of Saudi payers. Methods and materials: A prevalence-based budget impact model was developed to evaluate the financial effects of introducing "environment without" versus "with infliximab SC." The model's time horizon spanned over 2 years (2021–2023), aligning with the biennial national pharmaceutical procurement cycle. The comparison focused on infliximab SC versus all available formulations of infliximab IV in the Saudi market for two inflammatory bowel diseases (IBD): Ulcerative Colitis (UC) and Crohn's Disease (CD). Treatment comparators' comparability and dose escalations were substantiated by published studies, utilizing dosing information from the summary of product characteristics. Drug acquisition costs were derived from SFDA registered prices, with IV formulation administration costs included. Scenario analysis assessed the budget impact of infliximab SC introduction at uptake rates ranging from 0% to 100%. Results: Introducing infliximab SC demonstrated cost-saving potential in the treatment of IBD. At 100% uptake with UC patients for 2 years, infliximab SC resulted in savings of -SAR-31.9 million (-SAR29,145 per patient). Similarly, for CD, introducing infliximab SC at 100% uptake over 2 years yielded savings of -SAR106.2 million (-SAR36,585 per patient). Conclusion: This study reveals that infliximab SC is associated with cost-saving potential when compared to infliximab IV formulations available in Saudi Arabia. Future research should address uncertainties related to real-world comparative effectiveness, the convenience of administration, patient tolerability, and physician acceptance of the SC formulation of infliximab, alongside comparisons with other TNF-alpha inhibitors. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONThis study explored parents’ expectations before their youth with a disability attended a Residential Immersive Life Skills (RILS) program, and perceptions of youth change over the following 12 months. Understanding expectations is important because parents play a key role in shaping their youth’s ongoing development and future hopes when they return home.A secondary analysis of qualitative interviews with 13 parents was conducted using a recurrent cross-sectional analysis approach at three time-points: before youth attended a RILS program, and three and 12 months post-program.Before the RILS program, most parents focused on “concrete” life skills (e.g., self-care, budgeting), with some hoping for more youth self-awareness. After three months, many expectations were exceeded, leading some parents to re-evaluate their youth’s future. By 12 months, expectations had evolved further, although some parents expressed disappointment in perceived lack of change. Many parental expectations had been initially implicit and unstated.Exploring parental expectations of RILS programs is critical, as parents can both enhance and diminish their youth’s personal growth and future aspirations. Parents should understand how RILS programs may (or may not) change both the youth and the family dynamic upon return home.Parental expectations of paediatric rehabilitation services are often unstated yet can influence outcomes.Parents can both enhance and limit further personal growth in youth who attend Residential Immersive Life Skills (RILS) programs once they return home.Both parental and youth expectations should be explicitly explored prior to youth attending RILS programs.Tailored resources for parents could help them support their youth’s ongoing growth and future aspirations.Parental expectations of paediatric rehabilitation services are often unstated yet can influence outcomes.Parents can both enhance and limit further personal growth in youth who attend Residential Immersive Life Skills (RILS) programs once they return home.Both parental and youth expectations should be explicitly explored prior to youth attending RILS programs.Tailored resources for parents could help them support their youth’s ongoing growth and future aspirations. [ABSTRACT FROM AUTHOR]

ABSTRACT The recent global trend is the convergence of information and communications technology (ICT). By applying ICT in various fields such as the humanities, new types of products and services are created, and new values that help people's lives can be created. AI can be selected as a representative technology in such convergence ICT. However, applying AI technology to actual production requires ensuring data security. Federated learning (FL) can achieve secure sharing of data, where all parties participate in model training locally and upload it to the server for aggregation. The data never leaves the parties involved, thus solving the problems of data privacy and data silos. However, FL faces issues such as high communication cost, imbalanced performance distribution among participants, and low privacy protection. To achieve a balance between model accuracy, communication cost, fairness, and privacy, this paper proposes a multi‐objective optimization‐based FL algorithm (M‐FedAvg). The multi‐objective optimization problem of maximising the accuracy of the global model, minimising the communication cost, minimising the variance of the accuracy, and minimising the privacy budget is solved by NSGA‐III. The experimental results show that the algorithm proposed can effectively reduce the communication cost of FL and achieve privacy protection for participants without affecting the accuracy of the global model. [ABSTRACT FROM AUTHOR]

Spurred by the simultaneous need for data privacy protection and data sharing, federated learning (FL) has been proposed. However, it still poses a risk of privacy leakage in it. This paper, an improved Differential Privacy (DP) algorithm to protect the federated learning model. Additionally, the Fast Fourier Transform (FFT) is used in the computation of the privacy budget , to minimize the impact of limited arithmetic resources and numerous users on the effectiveness of training model. Moreover, instead of direct analyses of the privacy budget through various methods, Privacy Loss Distribution (PLD) and privacy curves are adopted, while the number of artificial assignments hyperparameters is reduced, and the grid parameters delineated for FFT use are improved. The improved algorithm tightens parameter bounds and minimizes human factors' influence with minimal efficiency impact. It decreases the errors caused by truncation and discreteness of PLDs while expanding the discreteness interval to reduce the calculation workload. Furthermore, an improved activation function using a temper sigmoid with only one parameter , smooths the accuracy curve and mitigates drastically fluctuating scenarios during model training. Finally, simulation results on real datasets show that our improved DP algorithm, which accounts for long trailing, facilitates a better balance between privacy and utility in federated learning models. [ABSTRACT FROM AUTHOR]

ABSTRACT We present empirical evidence on the relationship between military spending and the expansion of other government budget items and tax revenues from the unification of Italy (1861) up to the end of World War II. Until 1922, investments in education and social transfers to families mainly moved in step with defence spending. This means that increases in defence spending imply an increase in both education spending and transfers. Moreover, transfers also play a compensatory role during recessions. Increases in defence spending do not crowd out investment in capital expenditure, while disinvestment in defence is associated with an increase in investment in capital. The pro‐cyclical behaviour of tax revenues is compatible with the debt‐financing dynamic of much government expenditure. Although our analytical narrative is not universally valid, it does support the persistent centrality of external wars in the discontinuous growth and expansion of central government in the Italian state, with some exceptions explained by historical events. [ABSTRACT FROM AUTHOR]

New JWST observations are revealing the first galaxies to be prolific producers of ionizing photons, which we argue gives rise to a tension between different probes of reionization. Over the last two decades, a consensus has emerged where star-forming galaxies are able to generate enough photons to drive reionization, given reasonable values for their number densities, ionizing efficiencies |$\xi _{\rm ion}$| (per unit ultraviolet luminosity), and escape fractions |$f_{\rm esc}$|⁠. However, some new JWST observations infer high values of |$\xi _{\rm ion}$| during reionization and an enhanced abundance of earlier (⁠|$z\gtrsim 9$|⁠) galaxies, dramatically increasing the number of ionizing photons produced at high z. Simultaneously, recent low- z studies predict significant escape fractions for faint reionization-era galaxies. Put together, we show that the galaxies we have directly observed (⁠|$M_{\rm UV} < -15$|⁠) not only can drive reionization, but would end it too early. That is, our current galaxy observations, taken at face value, imply an excess of ionizing photons and thus a process of reionization in tension with the cosmic microwave background and Lyman- |$\alpha$| forest. Considering galaxies down to |$M_{\rm UV}\approx -11$|⁠ , below current observational limits, only worsens this tension. We discuss possible avenues to resolve this photon budget crisis, including systematics in either theory or observations. [ABSTRACT FROM AUTHOR]

Motivation: Policy‐makers dealing with conflicting development goals and constrained budgets must comprehend the relative cost effectiveness of agricultural and rural development initiatives. Purpose: We assess the impact of alternative interventions on development outcomes—economic growth, job creation, poverty reduction, and diet quality—to inform decision‐making and resource allocation in Tanzania's agriculture. We analyse trade‐offs among development objectives and explore budget reallocation to enhance the efficiency of public spending. Approach and methods: We used a computable general equilibrium (CGE) model linked top‐down with microsimulation modules to simulate the impact of public investment options. Findings: No single option emerges as the most effective across all development objectives. Investments in improved inputs and extension for horticulture and cash crops stand out for diet quality and employment creation. Livestock services show consistently high rankings across multiple objectives. Investments to boost cereals and root crops promote growth and reduce poverty but do little to increase employment and diet quality. Budget reallocation towards more cost‐effective interventions can significantly enhance the development effectiveness of Tanzania's agricultural expenditures and would substantially increase cumulative gross domestic product growth between 2019 and 2028. Policy implications: Policy‐makers can use the findings to design and prioritize agricultural interventions that better align with broader development objectives. Tanzania can achieve higher benefits and contribute to overall development goals by reallocating resources towards more cost‐effective expenditure options. [ABSTRACT FROM AUTHOR]

Ransomware is a menace to the vibrant digital ecosystem. The exponential growth in ransomware attacks, its detrimental impacts, and the ever‐changing methods adopted by threat actor groups demands a focused understanding of the evolution of ransomware. This would help the organizations devise novel defensive frameworks and security controls against the modern ransomware. In this work, the impacts and evolution of ransomware through different phases up to its current form are detailed. Further, based on the study and analysis of the most prevalent modern ransomware variants, their most used tactics, techniques and procedures (TTPs) are identified as per the MITRE ATT&CK model. This acts as a platform to propose a generic attack model for "modern ransomware." Building on the existing MITRE mitigation, D3FEND‐based approaches and considering the resource and budget constraints of organizations, a simplified three‐tier defensive model that is cost‐effective and implementable is put forward. Thus, this work aims to open avenues for understanding the TTPs, and attack methodology of "modern ransomware," thereby developing feasible and implementable defensive security controls. [ABSTRACT FROM AUTHOR]

Justice‐involved youth (JIY) display skills deficits in a variety of domains, but particularly in life skills such as health habits, obtaining a job, and maintaining finances. These skills are particularly important for JIY, who often come from historically disenfranchised communities. This population encounters many challenges as they transition from juvenile correctional facilities to their respective communities. To have the greatest impact, these skills should likely be taught prior to the transition. Thus, the purpose of this study was to teach basic personal finance skills to adolescent males in a juvenile residential treatment facility, using an information packet with rehearsal and feedback. The intervention was specifically chosen to be minimally invasive due to the challenges presented by the COVID‐19 pandemic relating to providing services to JIY. Data were analyzed visually using nonconcurrent multiple baseline designs. The results of the study showed the intervention was moderately effective at teaching basic financial skills relating to budgeting, banking, and credit to four participants. [ABSTRACT FROM AUTHOR]

Designing maintenance strategies for a vast portfolio of aging infrastructures requires decision-makers to ensure adequate safety levels while addressing the requirements on service interruptions, costs, and workforce availability. This study addresses the problem of scheduling maintenance interventions for a portfolio of bridges, aiming to minimize C O 2 emissions while meeting minimum reliability requirements and adhering to workforce and budget constraints. To achieve this, we present a Simheuristic algorithm that combines a metaheuristic core based on the Adaptive Large Neighborhood Search metaheuristic with a Monte Carlo simulation module. This integration allows for the evaluation of optimized scheduling solutions, accounting for the inherent randomness in the structural deterioration process. The proposed approach is tested in a comparative analysis against traditional time-based and condition-based scheduling methods. Results from diverse bridge portfolios demonstrate that the proposed algorithm offers improved performance in terms of both total costs and C O 2 emissions. [ABSTRACT FROM AUTHOR]

Core facilities are crucial for cutting‐edge scientific research in academic institutions, yet they place a significant financial burden on budgets. The viability of these facilities can be improved through cross‐institutional collaborations, although initiating and sustaining such partnerships poses challenges. Insights from Israel's recent nationwide organization of core facilities could offer valuable lessons for fostering similar cooperation elsewhere. Despite the chronic shortfall in public research funding, Israeli research institutions were slow to fully embrace infrastructure sharing. This gap led to the creation of the Israel Research Core Facilities (IRCF) in 2022, which linked core facilities across the country through a bottom‐up approach. IRCF facilitated the formation of numerous specialized nation‐wide networks for intellectual exchange, and supported training workshops and meetings aimed at core technology providers. These initiatives serve dual purposes: they ensure the ongoing advancement of technological capabilities across facilities, regardless of their size or location, and they strengthen the commitment to the IRCF mission by motivating the maintenance of the IRCF database. As a result, a model of "capacity sharing" emerged, connecting all of Israel's core facility centers. This model enhances infrastructure use, supports strategic planning, and fosters growth. With over 450 core experts offering over 1100 scientific services consolidated into a publicly accessible database, IRCF supports research in universities, hospitals, government, and industry. This strategy could act as a model for creating regional core facility organizations to elevate research quality and ensure efficient infrastructure development. [ABSTRACT FROM AUTHOR]

Twenty-one-centimetre signals from the Epoch of Reionization (EoR) are expected to be detected in the low-frequency radio window by the next-generation interferometers, particularly the Square Kilometre Array (SKA). However, precision data analysis pipelines are required to minimize the systematics within an infinitesimal error budget. Consequently, there is a growing need to characterize the sources of errors in EoR analysis. In this study, we identify one such error origin, namely source blending, which is introduced by the overlap of objects in the densely populated observing sky under SKA1-Low's unprecedented sensitivity and resolution, and evaluate its two-fold impact in both the spatial and frequency domains using a novel hybrid evaluation (HEVAL) pipeline combining end-to-end simulation with an analytic method to mimic EoR analysis pipelines. Sky models corrupted by source blending induce small but severe frequency-dependent calibration errors when coupled with astronomical foregrounds, impeding EoR parameter inference with strong additive residuals in the two-dimensional power spectrum space. We report that additive residuals from poor calibration against sky models with blending ratios of 5 and 0.5 per cent significantly contaminate the EoR window. In contrast, the sky model with a 0.05 per cent blending ratio leaves little residual imprint within the EoR window, therefore identifying a blending tolerance at approximately 0.05 per cent. Given that the SKA observing sky is estimated to suffer from an extended level of blending, strategies involving de-blending, frequency-dependent error mitigation, or a combination of both, are required to effectively attenuate the calibration impact of source-blending defects. [ABSTRACT FROM AUTHOR]

Introduction Previous evidence suggests the tobacco industry uses media to disseminate misleading narratives relating to illicit tobacco trade (ITT) as part of efforts to influence policy outcomes. Such evidence is largely high-income countries (HIC) focused, resulting in a literature gap for low- and middle-income countries (LMICs). Pakistan and its annual budget cycle are used as a case study for addressing this gap. Aims and Methods Electronic English-language articles from newspapers in Pakistan (328) were sourced from LexisNexis and a sub-sample of Urdu-language electronic articles (12) were identified through internet searches. The articles were published between 2015 and 2020 and included claims/estimates relating to ITT, which were coded to identify cited data sources. Changes in media coverage before and after Pakistan's annual budget announcements were explored via Wilcoxon signed rank and Poisson regression tests. Results Of the 357 claims/estimates analyzed, 66 (20%) were industry-funded. The most prevalent sources were national government bodies (36.6%) and tobacco companies or their representatives (15.1%). Wilcoxon signed-rank and Poisson regression tests on the frequency of English-language articles both created a p -value of < .05 for the frequency of relevant articles between the months of April and May, compared to the other months, indicating statistical significance. Conclusions There was a statistically significant increase in the number of English-language articles featuring claims/estimates relating to Pakistan's ITT in the months leading up to the annual budget each year. The government should consider measures to improve transparency standards within media coverage and promote factcheck journalism to safeguard against industry tactics to manipulate public discourses. Implications This paper is, to the best of our knowledge, the largest exploration of the use of data sourced from the tobacco industry within a country's media that has been undertaken to date, utilizing a team of seven coders across the United Kingdom and Pakistan. Our findings reveal weaknesses within media coverage of ITT in Pakistan, both in English and Urdu language publications. We encourage the government to consider new standards to enhance transparency and promote factcheck journalism within media coverage in the country. [ABSTRACT FROM AUTHOR]

This study mainly investigated the dynamic synoptic eddy (SE) feedback to interdecadal change in the impact of the winter Siberian high (SH) on subsequent ENSO development. It was found that a significant negative SH-ENSO correlation dominated since the mid-1980s (denoted as P2), which was extremely weak before the 1980s (denoted as P1). By applying a transformed vorticity budget analysis, focus was paid on the North Pacific where the air-sea responses linking the SH and ENSO development were closely associated with SE feedback. When the SH was anomalously enhanced, the Aleutian Low (AL) responded over the North Pacific. The dynamic SE feedback during P2 positively contributed to maintain the AL until early summer, induced the generation and intensification of an anomalous subtropical anticyclone, and thereby formed the negative North Pacific Oscillation phase. These air-sea responses favored the occurrence of Bjerknes feedback established around summer and finally grew into a La Niña event. During P1, the AL could hardly persist due to the rapid decay of dynamic SE feedback in spring, making the subsequent air-sea responses penniless. The distinct dynamic SE feedback was primarily because the intensity of spring SE activity was significantly weaker during P2 than during P1. By utilizing SE structure decomposition, it was found that the SE structure is more prone to being changed during P2, resulting in the generation of SE vorticity fluxes with a larger magnitude through multiplying basic SE velocity by anomalous SE vorticity and obtaining the SE forcing. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore if and how urban school districts explicitly addressed the needs of Black students within their budgets. Culturally responsive school leadership was used to examine district leaders' budgetary actions. Using content analysis methods and randomized purposeful sampling, we reviewed budget plans from districts with the largest percentages of Black students. We found that 7 of 11 districts included Black students in their plans. However, actions and expenditures did not clearly specify if or how they would support Black students. Recommendations include explicitly incorporating actions and expenditures into plans that directly target Black students. [ABSTRACT FROM AUTHOR]

Project bundling has been introduced as an innovative approach that groups several infrastructure projects into a single contract. Project bundling has numerous benefits such as expediting project delivery, capitalizing on economies of scale, and reducing the overall contract cost. However, agencies implementing project bundling also face some challenges, one of which is assessing the feasibility of a certain project delivery method (PDM) of interest. While different PDMs could be used for bundled projects, design-build (DB) has attracted particular interest from project owners as an alternative, innovative PDM due to its numerous benefits related to project performance. While previous research efforts examined different aspects of project bundling in terms of its decision-making factors, opportunities, and challenges, no previous research effort was devoted to studying the feasibility or applicability of the DB delivery method for bundled projects. To that extent, and to fill this gap, this paper develops a scoring framework that assesses the feasibility of the DB delivery for bundled projects. First, a questionnaire survey was distributed to industry experts to quantify the importance of 25 project bundling objectives. Second, principal component analysis (PCA) was implemented to calculate a weight for each project bundling objective. Third, a score for each project bundling objective was calculated and the DB feasibility tiers were identified using a series of statistical tests. Finally, a user-friendly feasibility scoring framework was developed to assign a feasibility score for the DB delivery method based on the user's inputs related to the bundled project of interest. The results showed that the key project bundling objectives that mostly increase the feasibility score of the DB delivery method for bundled projects are (1) Having specific scheduling, sequencing, staging, and phasing; (2) Meeting tight milestones or deadlines (timely completion of individual phases); and (3) Completing the overall project on schedule. Ultimately, this research adds to the body of knowledge by equipping agencies and project owners with a decision-support system that helps them make the go/no-go decision for the DB delivery method for their bundled projects. By making the right PDM decision, project owners can enhance their bundling practices (especially in relation to the PDM selection), reduce the associated risks and challenges, improve the overall schedule of the bundled program, and keep the cost within the identified budgets. [ABSTRACT FROM AUTHOR]

Construction projects, characterized by their significant budget, time, and resource demands, necessitate effective leadership. Existing research has predominantly focused on identifying ideal leadership styles for construction leaders, often overlooking the impact of "bad" leadership. This paper addresses this gap by exploring Machiavellian leadership within construction projects. Utilizing qualitative methods, 30 interviews with construction organization members were conducted to explore communication strategies employed by Machiavellian leaders and their impact on employee voice in construction organizations. The findings reveal that leader communication strategies are shaped by a combination of their Machiavellian personality, the context of the construction industry, and national culture. Furthermore, the impact of leaders' communication strategies on employee voice depends on the Machiavellian tendencies of both the leader and the employee. This research offers a nuanced and informed research agenda that aligns with emerging industry needs, bridging the gap between theory and practice in construction project leadership. [ABSTRACT FROM AUTHOR]

From a technical and economic point of view, cold gas propulsion for nanosatellites is one of the more rational systems. There is a problem, however: the optimal spherical shape for a high-pressure vessel only takes up half the cubic volume of the CubeSat unit. To increase the volume, it is proposed to switch to a cubic-shaped tank. The aim of this work is to synthesize the more rational structural design of a pressurant tank that fits within a cubic constraint, which provides the perfect balance between the mass of the structure and the delta-V budget available for the propulsion system. The proposed variants are as follows: a set of four cylinders with spherical bottoms; 14 equal spheres arranged in a face-centered cubic packing; a thin-walled cube supported by ribs, the location and parameters of which provide the smallest mass of the structure; a cube, the reinforcement scheme of which is calculated using topology optimization method; an original polyspheric and bypass design schemes where the filling of the volume of the cube is created by a set of spherical and cylindrical shells of different radii. All the considered vessel variants can be obtained using additive technologies, such as selective laser sintering. For each variant, the internal volume and mass of the vessels were obtained, as well as the delta-V budget, taking into account the mass of the tank and the mass of the stored gas. The analysis of the results reveals that there are two structures that are more rational. The new bypass scheme provides the largest delta-V budget, but it has a 1.6 times larger mass than the initial spherical vessel design. It should be noted that the difference in vessel mass is not crucial for CubeSat form factor satellites. Choosing a rational design may require a larger delta-V budget. The possibility of increasing the reserve delta-V of the CubeSat cold gas propulsion system by 25–35 % due to the transition from a spherical to a cube-shaped tank has been demonstrated. At the same time, the mass of the tank structure increases by 1.6–6.3 times, which can be considered an acceptable price for increasing the efficiency of the propulsion system. The new bypass scheme offers the optimal balance of mass and delta-V reserve. • Increasing the delta-V budget of the CubeSat cold gas propulsion system by 25–35 %. • Transition from a spherical pressure vessel to a conformable pressure vessel. • The new vessel design scheme gives the largest delta-V budget, is proposed. • Considered variant of vessel can be obtained using additive technologies. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to understand how healthcare practitioners experience organisational boundaries and silos in day-to-day operations. Based on a multi-dimensional scale of organisational boundaries, the study examines how organisational demarcation lines enable and constrain daily work tasks in the healthcare sector. Research design: The study is based on a quantitative and qualitative analysis of survey responses from 895 healthcare practitioners in Denmark. Results: The results indicate that tendencies toward organisational silos relate to systems and hierarchies (management-staff) rather than professions and departments. Moreover, the study identifies resource scarcity as an important undercurrent in the understanding of the respondents' perceptions of boundaries and silos. Conclusion: The study contributes to existing research by documenting the coordination and collaboration challenges linked to the multitude of demarcation lines in complex health organisations. [ABSTRACT FROM AUTHOR]

Some water distribution pipe networks were constructed several decades ago and have been damaged. The old pipe network has experienced many leaks and should be rehabilitated. In old cities like Jakarta, with high leak rates (1.6 leaks/km/year), pipeline network managers must frequently repair leaks or perform reactive maintenance. Far too many pipes need to be rehabilitated compared to the available budget. This research will develop an optimization model for selecting rehabilitated pipes under reactive maintenance conditions, which has never been performed before. The selection of pipe segments to be rehabilitated must be optimal to obtain maximum benefits using minimum costs. The variables that influence rehabilitation costs and benefits and the relationship between these variables need to be known to optimize the selection. The influencing variables and their model structure were obtained from literature reviews and surveys of respondents with sufficient experience in water pipe network management. These influential variables have varying characteristics. Data processing and analysis uses the confirmatory factor analysis (CFA) method with a formative–formative measurement model. In total, 22 variables were found to be valid and significantly influenced the cost and benefits of rehabilitation. The analysis results are a structural model of the relationship between variables that influence the costs and benefits of rehabilitation in reactive maintenance with a limited budget, which can be used to optimize rehabilitation models. [ABSTRACT FROM AUTHOR]

Federated Learning (FL), as a distributed machine learning method, is particularly suitable for training models that require large amounts of data while meeting increasingly strict data privacy and security requirements. Although FL effectively protects the privacy of participants by avoiding the sharing of raw data, balancing the risks of privacy leakage with model performance remains a significant challenge. To address this, this paper proposes a new algorithm—FL-APB (Federated Learning with Adversarial Privacy–Performance Balancing). This algorithm combines adversarial training with privacy-protection mechanisms to dynamically adjust privacy and performance budgets, optimizing the balance between the two while enhancing and ensuring performance. The experimental results demonstrate that the FL-APB algorithm significantly improves model performance across various adversarial training scenarios, while effectively protecting the privacy of participants through adversarial training of privacy data. [ABSTRACT FROM AUTHOR]

The ups and downs of climate policy uncertainty (CPU) cast a captivating shadow over the budgets allocated to renewable energy (RE) technologies, where strategic choices and risk assessment will determine the course of our green environmental revolution. The main intention of this investigation is to scrutinize the effect of CPU on the RE technology budgets (RETBs) in the top 10 countries with the highest RE research and development budgets (the USA, China, South Korea, India, Germany, the United Kingdom, France, Japan, Australia, and Italy). Although former researchers have typically employed panel data tools to contemplate the connection between CPU and RE technology, they repeatedly ignored variations in this connection throughout different economies. In contrast, our research adopts a unique approach, "quantile‐on‐quantile," to check this association at the country‐to‐country level. This approach offers a comprehensive worldwide perspective while procuring tailor‐made perceptions for individual economies. The outcomes suggest that CPU significantly decreases RETBs across several data quantiles in our sample nations. In addition, the outcomes underscore that the connections between our variables differ among nations. These outcomes highlight the significance of policymakers implementing thorough appraisals and skillfully governing plans relevant to CPU and RETBs. [ABSTRACT FROM AUTHOR]

Farmed aquaculture species play an important role in regulating nutrient cycles in farming systems. Compared with nitrogen and phosphorus, the role of farmed species in the silicon (Si) cycle remains poorly understood. To help reduce this uncertainty, we clarified the sources and sinks of silicate and quantified the Si pools in an aquaculture system in Sanggou Bay (SGB). The results showed that dissolved inorganic nutrient levels were significantly lower during the dry season than during the wet. Dissolved silicate (DSi) is a potential limiting factor for phytoplankton growth during spring, and phosphorus limitation occurs during summer. The budget results indicated that large amounts of nitrogen, phosphate (DIP), and DSi were buried in the sediment or transformed into other forms during both the wet and dry seasons. The nitrogen and DIP cycles were strongly influenced by bivalve excretion and farmed species harvesting; however, these processes had little impact on the Si cycle. Si availability depends on both external inputs and internal recycling. DSi was primarily supplied from the Yellow Sea, with a minor contribution from the river due to river discharge during spring. However, during summer, riverine inflow (accounting for 83% of the total influx) was the major DSi source followed by benthic flux (12%). Biogenic silica (BSi) burial efficiency in the sediment was estimated to be 78% during spring and 23% during summer. The BSi preservation efficiency in bivalves during spring was high (53%), leading to a higher Si retention than in river discharge. Bivalves biodeposition plays an important role in the Si burial process. We suggest that this high retention is essentially controlled by the biodeposition mechanism, which is directly controlled by the exotic suspension feeders. Bivalves have the potential to alter Si retention in the bay by producing large amounts of biodeposits and accelerating the silica cycle, which may lead to more carbon dioxide being absorbed by diatoms. [ABSTRACT FROM AUTHOR]

Introduction: Gastroesophageal reflux disease (GERD) is a common ailment associated with troublesome symptoms. The standard of care in Italy involves initial treatment with proton pump inhibitor (PPI)-based medical management or laparoscopic Nissen fundoplication (LNF) for patients unwilling to continue or intolerant of long-term PPI therapy. RefluxStop is a novel medical device, intended for laparoscopic implantation, that has recently proven to be an efficacious and cost-effective treatment option for patients with GERD. This analysis aims to describe the short-term budget impact of introducing RefluxStop as a GERD treatment option within the Italian National Health Service (SSN). Methods: A model adherent to international best practice recommendations was developed to estimate the budget impact of introducing RefluxStop over a 5-year time horizon. Two scenarios were considered: one without RefluxStop (i.e., comprising PPI therapy, LNF, and magnetic sphincter augmentation using the LINX system); and one with RefluxStop (i.e., addition of RefluxStop to the three treatment options previously mentioned). Clinical benefits and costs associated with each intervention were included in the analysis. Results: Over 5 years, the introduction of RefluxStop resulted in avoidance of 95 surgical failures, 11 reoperations, and 64 endoscopic esophageal dilations. Introduction of RefluxStop resulted in an almost neutral impact on the existing budget with a 0.316% increase in the annual Italian SSN spending on GERD treatment. Conclusion: Introduction of RefluxStop as a GERD treatment option in Italy is likely to be associated with substantial clinical benefits and a marginal budget impact. [ABSTRACT FROM AUTHOR]

Once established, government spending programs tend to continue. A commonly held view is that spending inertia leads to unsustainable debt, ultimately requiring fiscal adjustments such as "sequestration." We show that by insuring against political turnover, inertia may reduce politicians' incentives to accumulate debt. However, large preexisting commitments and the prospect of future stabilization can lead to overspending to dilute past administrations' commitments. Finally, we show that political polarization amplifies incentives to prioritize inertial programs, potentially explaining the increased share of mandatory spending in the US budget. (JEL D72, E62, H61, H63) [ABSTRACT FROM AUTHOR]

Scholars and practitioners continue to examine the growing pretrial detainee population. These individuals have not been convicted of a crime, and yet they sit in detention, taxing jail facilities and their limited budgets. Pretrial risk assessment tools have been created to identify individuals who can be released prior to trial, without jeopardizing community safety. The current study revalidates items included in the Florida Pretrial Risk Assessment Instrument. Results suggest that most individuals on pretrial release do not commit new offenses or fail to appear for future court hearings. Similarities and differences between the original study and the revalidation are noted. The inclusion of assessing "community ties" is also explored. [ABSTRACT FROM AUTHOR]

IMPACT: This article presents a tool to assess levels of financial information (FI) use by politicians—the FIU Index. The index provides a multidimensional perspective, whereby items of information used are combined with the main types of meetings where FI is discussed (annual budgets and accounts), and also with members of political bodies (local council, parliament, executive, government, political committee, etc.) in which FI is used. Entities may be ranked as below or above the average of those considered for the analysis each year. The FIU Index evidences the need for improvement, so that politicians can make the best use of FI to improve decision-making and dialogue with various stakeholders. The importance of making financial information (FI) available to politicians is well recognized. However, despite the recent attention by scholars to the use of FI in political contexts and by politicians, empirical research has failed to produce accurate tools to assess the degree to which politicians make use of FI. This exploratory study proposes a new tool to analyse levels of FI use—the FIU Index. The level of use is assessed by the number of times an FI term is mentioned by politicians. A test case using the new index in Portuguese municipalities illustrates its potential. [ABSTRACT FROM AUTHOR]

Athlete maltreatment has become 'one of the greatest concerns faced by governing bodies, authorities and practitioners in sport' (Stirling 2009, p. 1901). Its causes broadly stem from: (1) the culture and authority structures in organised sport; (2) the limited legal rights of athletes; and (3) a fragmented system of organisational oversight. Cutting across these causes is the distinct 'policy mix' within the elite sport system itself. Drawing upon a theoretical framework located within 'new institutionalism' and an interpretive qualitative approach using document analysis and semi-structured interviews, this investigation focuses on how policy instruments (e.g. programmes, rules, budgets, etc.) combine to shape/reinforce the behaviour and views of athletes, coaches, and administrators. Findings show that the policy instruments within the existing hierarchical structure of the elite sport system are interconnected and complement each other to mutually facilitate the attainment of elite sport success. Overall, this study suggests that the mix of policy instruments aimed at achieving the state's sport/political objectives may sustain and reinforce maltreatment. [ABSTRACT FROM AUTHOR]

What happens when patients suddenly stop their medications? We study the health consequences of drug interruptions caused by large, abrupt, and arbitrary changes in price. Medicare's prescription drug benefit as-if-randomly assigns 65-year-olds a drug budget as a function of their birth month, beyond which out-of-pocket costs suddenly increase. Those facing smaller budgets consume fewer drugs and die more: mortality increases 0.0164 percentage points per month (13.9%) for each $100 per month budget decrease (24.4%). This estimate is robust to a range of falsification checks and lies in the 97.8th percentile of 544 placebo estimates from similar populations that lack the same idiosyncratic budget policy. Several facts help make sense of this large effect. First, patients stop taking drugs that are both high value and suspected to cause life-threatening withdrawal syndromes when stopped. Second, using machine learning, we identify patients at the highest risk of drug-preventable adverse events. Contrary to the predictions of standard economic models, high-risk patients (e.g. those most likely to have a heart attack) cut back more than low-risk patients on exactly those drugs that would benefit them the most (e.g. statins). Finally, patients appear unaware of these risks. In a survey of 65-year-olds, only one-third believe that stopping their drugs for up to a month could have any serious consequences. We conclude that far from curbing waste, cost sharing is itself highly inefficient, resulting in missed opportunities to buy health at very low cost ($11,321 per life-year). [ABSTRACT FROM AUTHOR]

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To stay competitive, firms regularly invest in innovation by supporting internal capital projects (funded and executed in-house) that explore new products and operational improvements. Each year, in a highly competitive process, managers from different functional units of the firm submit proposals (that include estimated costs and benefits) for such projects. Managers, because of their domain knowledge and expertise, are naturally better informed about the costs and benefits of their respective projects and can use this information strategically to secure funding. An example of such behavior is the under-reporting of the cost estimate of a project and subsequently requesting additional funding during the execution phase. Such strategic behavior not only affects the firm's ability to fund the best projects but is also costly. Motivated by this challenge of deciding the funding of such projects at a global agribusiness firm, we seek a mechanism that is both provably near-optimal for the firm and guarantees truthful reporting from managers. Our setting consists of a principal and multiple agents. In each time period, over an infinite horizon, each agent requests funding for a potential project from the principal. Before submitting his proposal, each agent privately estimates the project's cost and its benefit. If funded, each project is executed in one period. The principal's funding decisions are binary; that is, each project is either funded in full or not funded. The actual cost (benefit) of a funded project is realized on its completion and incurred (earned) by the principal. The agents earn utility from the experience and reputation gained in completing projects. In each period, the principal desires to keep the total spend below a budget but can borrow external money at a cost. Our main contribution is a practically appealing dynamic nonmonetary mechanism for internal capital allocation under which, for any ϵ>0 , (a) truth-telling forms an ϵ-Bayesian Nash equilibrium and (b) the principal's expected utility is within ϵ of the expected utility in the first-best setting. This paper was accepted by Karan Girotra, operations management. Supplemental Material: The online appendices and data files are available at https://doi.org/10.1287/mnsc.2022.01121. [ABSTRACT FROM AUTHOR]

Health authorities using cost-effectiveness analysis (CEA) for informing reimbursement decisions on health technologies increasingly require economic evaluations encompassing both CEA and budget impact analysis (BIA). Good Research Practices advocate that the economic and clinical assumptions underlying these analyses are aligned and consistently applied. Nonetheless, CEAs and BIAs often are stand-alone analyses used in different stages of the decision-making process. This article used policy reports and Ministerial correspondence to discuss and elucidate the role of budget impact and its relationship with cost-effectiveness in reimbursement decisions in the Netherlands. The results indicate that CEAs and BIAs are both considered important for informing these decisions. While the requirements regarding CEAs—and application of the associated decision rule—are consistent across the different stages, the same does not hold for BIAs. Importantly, the definition of and evidence on budget impact differs between stages. Some important aspects (e.g. substitution and saving effects) typically are considered in the assessment and appraisal stages but are seemingly not considered in price negotiations and the final reimbursement decision. Further research is warranted to better understand why BIAs are not aligned with CEAs (e.g. in terms of underlying assumptions), vary in form and importance between stages, and do not have a clear relationship with the results of CEAs in the decision-making framework. Improving the understanding of the circumstances under which decision-makers attach a relatively larger or smaller weight to (different aspects of) budget impact may contribute to increasing the transparency, consistency, and optimality of reimbursement decisions in the Netherlands. [ABSTRACT FROM AUTHOR]

Our objective was to compare AOTMiT (Polish: Agencja Oceny Technologii Medycznych i Taryfikacji) recommendations to other HTA (Health Technology Assessment) agencies for newly registered drugs and new registration indications issued by the European Medicines Agency between 2014 and 2019. The study aims to assess the consistency and justifications of AOTMiT recommendations compared to that of other HTA agencies in 11 countries. A total of 2496 reimbursement recommendations published by 12 HTA agencies for 464 medicinal products and 525 indications were analyzed. Our analysis confirmed that the Polish AOTMiT agency seems to bear the closest resemblance to the corresponding HTA agencies from Canada (CADTH) and New Zealand (PHARMAC), when it comes to the outcome of HTA recommendations (positive or negative). Poland had a general scheme for justifying recommendations, similar to that of Ireland—four aspects (i.e., clinical efficacy, safety profile, cost-effectiveness, and impact on the payer's budget) are important for Poland when formulating the final decision. Compared to other countries, Poland shows a noticeably different pattern of justifying reimbursement recommendations, as revealed primarily in terms of budget impact and somewhat less so for cost-effectiveness rationales. [ABSTRACT FROM AUTHOR]

Sodium-glucose co-transporter-2 (SGLT2) inhibitors such as Empagliflozin, are increasingly recommended as part of guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF) in many developed nations. This recommendation is based on robust clinical evidence showing that adding Empagliflozin to GDMT improves heart failure symptoms, clinical outcomes, functional status, and overall quality of life. In Malaysia, where healthcare is predominantly public and heavily subsidized, the introduction of new treatments can significantly impact costs, requiring detailed economic assessments. This study evaluates the budget impact of incorporating Empagliflozin into GDMT for HFrEF from the perspective of the public healthcare system. A five-year budget impact model was developed, integrating local data such as population, drug use, costs, clinical outcomes, and healthcare expenses. In the current scenario (GDMT alone), the projected five-year expenditure is MYR 6.12 billion (USD 3.92 billion). With Empagliflozin, the total cost rises by 0.71% to MYR 6.16 billion (USD 3.95 billion), driven by drug acquisition costs of MYR 160.12 million (USD 102.64 million) and adverse event costs of MYR 211,543 (USD 135,604). However, these costs are offset by savings from reduced HF hospitalizations, fewer cardiovascular deaths, and improved renal outcomes. Sensitivity analysis identified hospitalization costs, the price of Empagliflozin, and cardiovascular deaths in diabetic patients as key factors influencing the budget impact. Policymakers can improve the affordability of Empagliflozin through strategies like price negotiations, cost-sharing, and focusing on high-risk groups to optimize healthcare expenditure while ensuring effective treatment access. [ABSTRACT FROM AUTHOR]

Universities, as agents of change, are expected to contribute to society's most pressing challenges, particularly the 21st century's central issue of sustainability. Amid growing expectations from governments, society, and an increasingly conscientious student body, universities have undergone significant institutional adjustments to incorporate sustainability into their core missions of education, research, and outreach. As universities worldwide increasingly engage in sustainability practices, the question arises: How do these sustainability endeavours correlate with academic performance on a global scale? This article, using data from the QS Sustainability Ranking and four prominent academic ranking (THEWUR, ARWU, QSWUR and USWUR), investigates this link. The study explores whether sustainability relates to the academic performance of universities, the validity of the relationship when academic scores of the four rankings are aggregated, and its dependence on country-level sustainability performance scores. Findings reveal that sustainability practices have a reflection on the university rankings, providing a global competitive advantage for universities. While this study incorporates aggregated scores as a methodological innovation addressing the lack of uniformity among ranking systems, it recommends the inclusion of university-level control variables (such as faculty expertise, university budget, infrastructure) and government and policy variables in future studies to ensure robustness of the results. [ABSTRACT FROM AUTHOR]

Bangladesh's agriculture is highly rice-centric. Although economically rational, this is also risky, and arguably unsustainable. As a result, there is increasing interest in crop diversification (CD). This study examines the policy environment and the implementation of projects promoting CD in Bangladesh from 1971 to the present. An integrated analytical framework, developed by the International Wheat and Maize Improvement Center (CIMMYT) was used. Despite numerous policies and projects aimed at promoting CD, progress remains limited due to historical biases and various challenges. This research identifies a significant gap in existing approaches, which primarily focus on production aspects while neglecting market systems for new crops. Additionally, inadequate coordination among government agencies has impacted the effectiveness of projects implemented by development partners. The study highlights that CD efforts have been largely project-driven and short-lived, emphasizing the need for mainstreaming CD with dedicated annual funding to ensure long-term sustainability. Key challenges in funding, market development, and implementation are identified. The study recommends mainstreaming CD through annual budgets and enhancing market linkages. Furthermore, it provides actionable guidelines for policymakers and practitioners to effectively promote and sustain crop diversification in Bangladesh's agriculture. [ABSTRACT FROM AUTHOR]

Background: Decentralisation has increasingly been adopted by countries as an important health sector reform aimed at increasing community participation in decision making while enhancing swift response at decentralised levels, to accelerate the attainment of health system goals. Kenya adopted a devolved system of government where health services delivery became a function of the 47 semi-autonomous county governments with planning and budgeting functions practised at both levels of government. This study sought to explore challenges facing health sector planning and budgeting and how they affect immunisation service delivery at the county level. Methods: Data were collected through 77 in-depth interviews of senior county department of health officials across 15 counties in Kenya. We applied an inductive thematic approach in analysing the qualitative data using NVIVO software. Findings: The study found a lack of alignment between planning and budgeting processes, with planning being more inclusive compared to budgeting. Inadequate capacity in conducting planning and budgeting and political interference were reported to hinder the processes. Limited budget allocations and delayed and untimely disbursement of funds were reported to affect execution of health and immunisation budgets. Low prioritisation of preventive health interventions like immunisation due to their perceived intangibility influenced resource allocation to the programs. Conclusion: The findings highlight the need for effective strategies to align planning and budgeting processes, increased technical support to counties to enhance the requisite capacity, and efforts to improve budget execution to improve budget credibility. Counties should plan to increase their funding commitment toward immunisation to ensure sustainability of the program as Kenya transitions from GAVI support. [ABSTRACT FROM AUTHOR]