Physiological responses of tambaqui (Colossoma macropomum) fed diets supplemented with silage from fish and vegetables residues / Respostas fisiológicas de tambaqui (Colossoma macropomum) alimentado com dietas suplementadas com silagem de resíduos de pescado e vegetais

The demand for products to replace high-cost raw materials, such oil and fish meal, in the manufacture of feed for use in aquaculture, while also guaranteeing the nutritional quality of the diets, is increasing. Silage produced with fish and vegetables residues is a low-cost and efficient protein source. The objective of the present study was to evaluate the physiological and biochemical responses of tambaqui fingerlings fed four different levels of silage included in commercial feed with 28% crude protein, over two periods: 45 and 90 days. Each treatment was carried out over three replications, with 10 tambaqui in each 100 L experimental tank. At the end of each established period, blood samples were collected from five animals from each repetition to determine the hematological and biochemical variables. Body weight and total length, hepatosomatic and liposomal indices and hematocrit of specimens fed with diets supplemented with silage did not exhibit significant changes in both assessment period. After 45 days of feeding, the hemoglobin concentration increased when tambaqui were fed a diet including 20% silage. The red blood cell count, mean corpuscular volume and mean corpuscular hemoglobin did not change between treatments in either period. The total protein concentrations increased significantly in the plasma of tambaqui fed with diets with the inclusion of 5 and 10% of silage, evaluated after feeding for 45 days. It was found that the groups which had silage included in their diet did not exhibit significant alterations in the evaluated parameters, and the diet was therefore not consider harmful to the health of tambaqui. Therefore, the use of silage as a feed supplement during tambaqui farming is a sustainable alternative for producers, as it leads to a reduction of impacts of fish and vegetables waste disposal.

A procura por insumos que substituam produtos de alto custo, como óleo e farinha de peixe, na fabricação de rações para uso na aquicultura é crescente, sendo necessário garantir a qualidade nutricional das dietas. A silagem produzida a partir de resíduos de pescado e de vegetais apresenta-se como uma alternativa de baixo custo e eficiente fonte proteica. O objetivo do presente estudo foi avaliar as respostas fisiológicas e bioquímicas de alevinos de tambaqui alimentados com quatro níveis de inclusão de silagem em ração comercial com 28% de proteína bruta, em dois períodos: 45 e 90 dias. Cada tratamento foi realizado em três repetições, com 10 tambaquis em cada caixa experimental de 100 L. Ao término de cada período estabelecido, amostras sanguíneas foram coletadas de cinco animais de cada repetição para determinação das variáveis hematológicas e bioquímicas. Peso, comprimento total e índices hepatossomático e lipossomático de espécimes alimentados com silagem não mostraram alterações significativas em ambos os períodos de avaliação, bem como os valores de hematócrito. A concentração de hemoglobina de tambaqui após 45 dias de alimentação aumentou quando foi fornecida dieta com inclusão de 20% de silagem. A contagem de eritrócitos, volume corpuscular médio e hemoglobina corpuscular média não apresentaram alterações entre os tratamentos, em ambos os períodos. As proteínas totais aumentaram significativamente no plasma de tambaquis que receberam dietas com inclusão de 5 e 10% de silagem, avaliados após 45 dias de alimentação. Evidenciou-se que os grupos com inclusão de silagem na dieta não apresentaram alterações significativas nos parâmetros avaliados, assim não sendo prejudiciais à higidez do tambaqui. Portanto, o uso da silagem como suplemento alimentar durante o cultivo do tambaqui é uma alternativa sustentável para produtores, por promover a redução do descarte de resíduos de pescado e da agricultura.

A traveler-centric mobility game: Efficiency and stability under rationality and prospect theory.

In this paper, we study a routing and travel-mode choice problem for mobility systems with a multimodal transportation network as a "mobility game" with coupled action sets. We formulate an atomic routing game to focus on the travelers' preferences and study the impact on the efficiency of the travelers' behavioral decision-making under rationality and prospect theory. To control the innate inefficiencies, we introduce a mobility "pricing mechanism," in which we model traffic congestion using linear cost functions while also considering the waiting times at different transport hubs. We show that the travelers' selfish actions lead to a pure-strategy Nash equilibrium. We then perform a Price of Anarchy and Price of Stability analysis to establish that the mobility system's inefficiencies remain relatively low and the social welfare at a NE remains close to the social optimum as the number of travelers increases. We deviate from the standard game-theoretic analysis of decision-making by extending our mobility game to capture the subjective behavior of travelers using prospect theory. Finally, we provide a detailed discussion of implementing our proposed mobility game.

Availability, Cost, and Consumer Ratings of Popular Nonvalidated vs Validated Blood Pressure-Measuring Devices Sold Online in 10 Countries.

This study examines the availability, cost, and consumer ratings of blood pressure­measuring devices relative to validation status across 10 countries.

Cost Implications of Left Atrial Appendage Occlusion During Cardiac Surgery: A Cost Analysis of the LAAOS III Trial.

Background The LAAOS III (Left Atrial Appendage Occlusion Study) clinical trial demonstrated that concomitant left atrial appendage (LAA) occlusion leads to a lower risk of ischemic stroke or systemic embolism compared with no occlusion in participants with atrial fibrillation and a CHA2DS2-VASc score of ≥2 undergoing cardiac surgery for another indication. We report the cost implications of concomitant LAA occlusion during cardiac surgery. Methods and Results Using LAAOS III data, we compared the costs (in US dollars) associated with LAA occlusion to no occlusion from the perspective of the Centers for Medicare and Medicaid Services. We calculated the average cost per participant during the trial by applying Medicare reimbursement costs to cardiovascular events for all trial participants. We conducted sensitivity analyses, varying the cost of stroke ±25% and occlusion technique use. Cost neutrality was defined as a mean cost difference within ±5% of the cost per participant in the no-occlusion group. Total study cost per participant was $3878 in the LAA occlusion group and $4490 in the no-occlusion group, a mean difference of -$612 (95% CI, -$1276 to $45). The main drivers of cost savings were fewer stroke events during the trial (mean difference of -$1021). In sensitivity analyses, LAA occlusion was cost saving for suture and stapler techniques but more expensive with closure device. Conclusions Concomitant LAA occlusion was cost saving for participants in LAAOS III. Our findings support concomitant LAA occlusion as an economically dominant strategy for patients with atrial fibrillation and a CHA2DS2-VASc score of ≥2 undergoing cardiac surgery.

The impact of government subsidy and weather on environmentally sustainable investment decision for agricultural supply chain.

This paper studies the environmentally sustainable investment of an agricultural supply chain composed of a farmer and a company, under three subsidy policies which are the non-subsidy policy, the fixed subsidy policy, and the Agriculture Risk Coverage (ARC) subsidy policy. Then, we analyse the impact of different subsidy policy and adverse weather on the costs of the government and profits of the farmer and the company. By comparing with the non-subsidy policy, we find that both the fixed subsidy policy and the ARC policy encourage the farmer to improve the environmentally sustainable investment level and increase the profit of the farmer and the company. We also find that both the fixed subsidy policy and the ARC subsidy policy lead to an increase in government spending. Our results show that the ARC subsidy policy has a significate advantage in encouraging the farmer's environmentally sustainable investment if the adverse weather is relatively serious, comparing with the fixed subsidy policy. In turn, our results also show that the ARC subsidy policy is more beneficial for both the farmer and the company than the fixed subsidy policy if the adverse weather is relatively serious, which then leads to a higher expenditure of the government. Therefore, our conclusion serves as a theoretical basis for governments to formulate agricultural subsidy policies and promote sustainable development of the agricultural environment.

Hybrid channel structure and product quality distribution strategy for online retail platform.

Currently, platforms (such as Amazon.com and JD.com) are gradually transitioning from pure resellers to platforms providing hybrid channel structures. In a hybrid channel, the reselling channel and the agency channel on the platform are simultaneously used. Therefore, according to the agent who sells through the agency channel (manufacturer or third-party retailer), two kinds of hybrid channel structurers can be selected by the platform. At the same time, due to the intense competition caused by the hybrid channel structure, platforms take the initiative to implement the product quality distribution strategy in which different quality products are sold through various retailing channels. Thus, from the perspective of platforms, how to coordinate the selection of hybrid channel structures and the implementation of the product quality distribution strategy is a significant issue that has been overlooked in existing literature. This paper proposes game-theoretic models to investigate whether a platform should choose "which" hybrid channel structure to use and decide "whether" to adopt the product quality distribution strategy. Our analysis shows that the game equilibrium is affected by the commission rate, the product differentiation level, and the production cost. More specifically, first, it is interestingly found that if the product differentiation level exceeds a particular threshold, the product quality distribution strategy can negatively influence the retailer to abandon the hybrid retailing mode. In contrast, the manufacturer continues to sell through the agency channel as a part of the product distribution plan. Second, regardless of the channel configuration, we find that the platform chooses to increase the order quantity with the help of the product distribution plan. Third, contrary to popular belief, the product quality distribution strategy can only benefit the platform when the third-party retailer participates in hybrid retailing with a suitable commission rate and product differentiation level. Fourth, the platform should make decisions on the above two strategies concurrently; otherwise, agency sellers (manufacturer or third-party retailer) will oppose the product quality distribution strategy. Our key findings can assist stakeholders in making strategic decisions about hybrid retailing modes and product distribution.

Modeling Patient Treatment Trajectories Using Markov Chains for Cost Analysis.

Electronically stored medical records offer a rich source of data for investigating treatment trajectories and identifying best practices in healthcare. These trajectories, which consist of medical interventions, give us a foundation to evaluate the economics of treatment patterns and model the treatment paths. The aim of this work is to introduce a technical solution for the aforementioned tasks. The developed tools use the open source Observational Health Data Sciences and Informatics Observational Medical Outcomes Partnership Common Data Model to construct treatment trajectories and implement these to compose Markov models for composing financial analysis between standard of care and alternatives.

The Smart Data Extractor, a Clinician Friendly Solution to Accelerate and Improve the Data Collection During Clinical Trials.

In medical research, the traditional way to collect data, i.e. browsing patient files, has been proven to induce bias, errors, human labor and costs. We propose a semi-automated system able to extract every type of data, including notes. The Smart Data Extractor pre-populates clinic research forms by following rules. We performed a cross-testing experiment to compare semi-automated to manual data collection. 20 target items had to be collected for 79 patients. The average time to complete one form was 6'81" for manual data collection and 3'22" with the Smart Data Extractor. There were also more mistakes during manual data collection (163 for the whole cohort) than with the Smart Data Extractor (46 for the whole cohort). We present an easy to use, understandable and agile solution to fill out clinical research forms. It reduces human effort and provides higher quality data, avoiding data re-entry and fatigue induced errors.

Models of service delivery in adult cochlear implantation and evaluation of outcomes: A scoping review of delivery arrangements.

BACKGROUND: This study aimed to describe available evidence of cochlear implantation delivery arrangements in adults and the outcomes by which these service models are measured. METHODS: Scoping review of English language, primary studies conducted on adults (≥18 years) with ten or more subjects, published between January 2000 and June 2022, which assessed the effects of delivery arrangements of cochlear implantation were included. MEDLINE, EMBASE, CINAHL Plus, AMED, PsycINFO, LILACS, KoreaMed, IndMed, Cochrane CRCT, ISRCTN registry, WHO ICTRP and Web of Science were systematically searched. Included studies had to have a method section explicitly measure at least one of the Cochrane Effective Practice and Organization of Care (EPOC) outcome category. Criteria for systematic reviews and delivery arrangement category based on EPOC taxonomy was included in data extraction. Data was narratively synthesized based on EPOC categories. RESULTS: A total of 8135 abstracts were screened after exclusion of duplicates, of these 357 studies fulfilled the inclusion criteria. Around 40% of the studies investigated how care is delivered, focusing on quality and safety systems. New care pathways to coordinate care and the use of information and communication technology were emerging areas. There was little evidence on continuity, coordination and integration of care, how the workforce is managed, where care is provided and changes in the healthcare environment. The main outcome measure for various delivery arrangements were the health status and performance in a test. CONCLUSION: A substantial body of evidence exists about safety and efficacy of cochlear implantation in adults, predominantly focused on surgical aspects and this area is rapidly growing. There is a lack of evidence on aspects of care delivery that may have more impact on patients' experience such as continuity, coordination and integration of care and should be a focus of future research. This would lead to a better understanding of how patient's view CI experience, associated costs and the value of different care models.

Optimal number of charging station and pricing strategy for the electric vehicle with component commonality considering consumer range anxiety.

The battery driving mileage on a single charge and convenience of the charging stations affect Electric Vehicle's (EV) demand. This paper studies the optimal number of charging stations and EV's price strategy considering different component commonality configurations. Assume the EV manufacturer provides two types of EV and the two EVs have the same battery configuration (battery as a common part) or the same naked vehicle-EV without batteries (naked vehicle as a common part). And the common part could be configured with low or high quality. We discuss four scenarios with different common parts and different quality levels. For each scenario, we present the optimal number of the charging stations and EV prices. Then we compare the optimal solutions and manufacturer's profits in above four scenarios with numerical simulation and give some managerial insights. Our analysis reveals that (1) consumers' range anxiety towards battery will affect manufacturer's product configuration strategy, EVs' prices and demands. (2) large consumers' sensitivity towards charging station will corresponding to more charging station, high EV prices and demands. If consumers are very concerned about the charging convenience, high-end electric vehicles need to be launched first, then as customers' anxiety about charging decreases, the low quality EV could be developed and diffused. (3) the unit product cost reduction caused by the commonality may increase or decrease the EVs' prices, which depends on the relationship between the demand increment incurred by one more charging station and the cost coefficient of building the charging station. (4) The low quality naked vehicle as common component will increase both the number of the charging stations and the demand and the manufacturer is more likely to obtain high profits. (5) the cost saving coefficient of battery common parts has greater influence on the selection of commonality. When consumers' range anxiety towards battery is very high, manufacturers should choose low-quality naked vehicles or high-quality battery as common components.

Changes in Out-of-Pocket Costs for US Hospital Admissions Between December and January Every Year.

This cross-sectional study examines cost-sharing for ICU and non-ICU hospitalizations among adults with employer-sponsored insurance.

Optimal Decision-Making of Closed-Loop Supply Chains in E-Commerce Platform Considering Sales Cooperations under Environmental Effects and WEEE Regulations.

Nowadays, to achieve carbon neutrality, e-commerce platforms participate in the sales and recycling of electrical and electronic products in consideration of waste electrical and electronic equipment (WEEE) regulations and environmental effects. This study builds a Stackelberg game model for an e-commerce closed-loop supply chain (ECLSC) under different sales cooperation modes between a manufacturer of electrical and electronic products and an e-commerce platform. Reverse induction is used to obtain the optimal decision-making and profit of the ECLSC under three sales cooperation modes, considering the influence of environmental effects on optimal decision and objective functions. The results show the following: the sales cooperation mode and environmental cost do not affect the WEEE recovery prices of manufacturers and e-commerce platforms, nor do they affect government subsidy standards for dismantling WEEEs; they are, however, positively correlated with environmental benefits. Furthermore, the wholesale and retail prices of electrical and electronic products under different sales cooperation modes are related to sales cooperation modes and environmental costs. Moreover, the processing fees imposed on the manufacturers are related to the environmental costs of the electrical and electronic products; the thresholds of environmental costs of products for government to levy processing fees are different under different sales cooperation modes. Finally, the environmental cost of products required by the government's levying of processing fees are the lowest under a hybrid model. Generally speaking, under WEEE regulations, governments should levy more processing fees for electrical and electronic products with higher environmental costs. Meanwhile, increased environmental benefits will always increase the profits of supply chain members, but increased environmental costs do not always reduce the profits of supply chain members, and multichannel product sales do not always generate profits for manufacturers.

An eConsultant versus a hospital-based outpatient consultation for general (internal) medicine: a costing analysis.

BACKGROUND: The eConsultant model of care is an outpatient substitution approach which has been evaluated and implemented extensively internationally. It provides an asynchronous, digital, clinician-to-clinician advice service, giving primary care physicians remote access to specialist support for patient care within 3 business days. Results from initial trials of the eConsultant model in Australia support international evidence of reduced wait times and improved access to specialist input, avoidance of face-to-face hospital outpatient visits, and better integrated care. This study compared the cost of delivery of an eConsultant episode of care with that of a hospital-based outpatient appointment. METHODS: A cost-minimisation analysis, using a decision analytic model, was used to compare the two approaches. eConsultant costs were calculated from specialist reported data (minutes spent preparing the response; the number of patients referred subsequently for a hospital-based outpatient appointment) and administration staff data (time spent recording the occasion-of-service). Outpatient costs were calculated using finance data and information from outpatient clinic managers at the hospital-based outpatient clinic. The primary outcome was incremental cost saving per patient from a hospital system perspective. Uncertainty was explored using one-way sensitivity analyses and characterised with probabilistic sensitivity analysis using 10,000 Monte Carlo simulations. RESULTS: The traditional referral pathway cost estimate was $587.20/consult compared to $226.13/consult for an eConsultant episode: an efficiency saving of $361.07 per patient. The incremental difference between eConsultant and traditional care was most sensitive to the cost estimate of an outpatient attendance, the time for a specialist to complete an eConsult, and the probability of a patient requiring a face-to-face hospital-based attendance following an eConsult. However, at the upper bounds of each of these estimates, an eConsult remained the most cost-efficient model. In 96.5% of the Monte Carlo simulations eConsult was found to be more cost efficient than the traditional approach. CONCLUSIONS: The eConsultant model of care was associated with a 61.5% efficiency gain, allowing diversion of support to hospital-based outpatient appointments.

Intravenous compounding robots in pharmacy intravenous admixture services: A systematic review.

BACKGROUND: There is a lack of best evidence of intravenous compounding robots for hospital decision-makers. This study aimed to conduct a systematic review of intravenous compounding robots. METHODS: A comprehensive search of relevant professional health technology assessment websites and electronic databases was conducted from inception to February 3, 2022. Current studies related to intravenous compounding robots were included in this systematic review. Two reviewers independently screened the literature, extracted data, and assessed quality. The results were reported by qualitative description because of heterogeneity in the characteristics of the data in the included studies. RESULTS: Thirty-three studies were included. Effectiveness: The robots improved production efficiency compared with usual/manual preparation; however, the intravenous preparation process requires further optimization. Additionally, robots reduced the incidence of medicine residues, preparation errors, and preparation failures. The solution properties of intravenous admixture medicines were satisfactory, and the robots also contributed to error recognition. Safety: The robots reduced product pollution and environmental pollution, but vigilance is still required to ensure that pollution stays low. The robots also reduced the incidence of health damage to technicians. Economy: The robots reduced material costs in these studies; however, whether they can reduce labor costs remains unclear. Social suitability: Technicians had a high degree of satisfaction with the robots, but few relevant studies focused on this aspect. CONCLUSIONS: Intravenous compounding robots have certain advantages in terms of effectiveness, safety, economy, and social adaptability.

A study on limited pre-sale strategy with consideration of consumer regret.

The effect of regret on consumers' purchasing behavior is more and more obvious. The limited pre-sale can make retailers with limited production capacity allocate two periods of stock effectively and increase their income. This paper considers the heterogeneous consumers with regret behavior in the market and constructs a model to study the retailer's optimal limited pre-sale strategy. The results show that the high price regret sensitivity negatively affects the higher price of the products in the pre-sale strategy, while the out-of-stock regret sensitivity negatively affects the retailer's profit When the production capacity is relatively low, the proportion of rational consumers is large and the high price regret sensitivity coefficient is small, the retailer should pre-sell at a limited discount and the lowest valuation, and the highest valuation is on sale, otherwise, it should be sold at a price slightly lower than the highest valuation, but when the capacity is very sufficient, the sensitive coefficient of stock-out regret is small and the proportion of rational consumers is small, the retailer should pre-sell at an unlimited premium, and a price slightly lower than the highest valuation of the pre-sale, the lowest valuation of the sale, or should be pre-sold at the highest valuation.

Strategies of property developers in the context of carbon tax.

China needs to guide property developers in actively reducing emissions to reach carbon emission reduction targets and respond to global climate change. A carbon tax is an important policy tool. Still, to establish successful rules to steer property developers' reasonable carbon emission reduction behavior, we must first explore property developers' decision-making mechanisms. This study develops an emission reduction and price game model for property developers under the constraint of a carbon tax. It then applies reverse order induction and optimization methods to identify the game equilibrium solution for property developers. Using the game equilibria, we explore the carbon tax mechanism on emission reduction and property developer pricing strategies. We can derive the following conclusions if the carbon tax policy is not implemented: 1.House prices are related to the substitutability of the two types of competitive property developers. 2.The greater the substitutability, the greater the cost of emission reduction paid by consumers. 3.The game equilibrium carbon emission intensity is the average carbon emission intensity of the housing business. In the situation of enacting a carbon tax, we arrive at the following conclusions: 1.The profits of real estate developers who do not have the advantage of emission reduction continue to decline with the increase of carbon tax. 2. For real estate developers who have the advantage of decreasing emissions, profits declined initially and then increased as the carbon tax rate increased, and only when the carbon tax rate reaches Tm1* can they fully leverage the cost advantage and obtain ever-increasing profits. 3.Low tax rates should be adopted by the government at the start of the implementation of the carbon tax policy to provide a buffer time for real estate developers who do not have the advantage of emission reduction costs.

The effects of carbon pricing instruments on carbon emission reduction in China's refining industry: an evolutionary game between heterogeneous refineries.

Carbon emissions from the refining industry are receiving increasing national attention. In view of long-term sustainable development, a carbon pricing mechanism oriented to carbon emission reduction needs to be developed. Currently, the two most common carbon pricing instruments are emission trading system and carbon tax. Therefore, it is important to study the carbon emission problems in the refining industry under emission trading system or carbon tax. Based on the current situation of China's refining industry, this paper constructs an evolutionary game model for backward and advanced refineries to explore which instrument is more effectively applied in the refining industry and identify the effective factors that can promote carbon emission reduction in refineries. According to the numerical results, if the heterogeneity of enterprises is small, the government's implementation of an emission trading system is the most effective measure, while carbon tax can only ensure that the equilibrium strategy solution is (1,1) when the tax rate is high. If the heterogeneity is large, the carbon tax policy will not have any effect, indicating that government implementation of an emission trading system is more effective than the carbon tax. In addition, there is a positive relationship between carbon price, carbon tax, and refineries' agreement to carbon emission reduction. Finally, consumers' preference for low-carbon products, R&D investment level, and R&D spillover effect have nothing to do with carbon emission reduction. Only by reducing refinery heterogeneity and improving the R&D efficiency of backward refineries can all enterprises agree to carbon emission reduction.

Persistent disparities in affordable rental housing among America's ethnoracial groups.

Housing and residential outcomes in the United States are significantly stratified by ethnoracial group, but the extent to which disparities exist in affordable renting over time is less clear. In this study, I explore affordable housing disparities among White, Black, Hispanic, and Asian renters and test hypotheses regarding variation by education, local ethnoracial composition, and chosen measurement of affordability. Chiefly, I find that White households have higher rates of affordable housing than Black and Hispanic households with disparities remaining nearly identical between 2005 and 2019 and become larger when considering household's ability to afford other basic needs. Nevertheless, returns to education are not uniformly larger for White renters, in that Black and Asian renters experience larger marginal increases in residual income based affordable housing at higher levels of education. The effects of county ethnoracial composition effects are consistent with all groups-including White households-experiencing declining affordability when living in counties with large coethnic populations.