The cost of treating severe refractory asthma in the UK: an economic analysis from the British Thoracic Society Difficult Asthma Registry

Severe refractory asthma poses a substantial burden in terms of healthcare costs but relatively little is known about the factors which drive these costs. This study uses data from the British Thoracic Society Difficult Asthma Registry (n=596) to estimate direct healthcare treatment costs from an National Health Service perspective and examines factors that explain variations in costs. Annual mean treatment costs among severe refractory asthma patients were £2912 (SD £2212) to £4217 (SD £2449). Significant predictors of costs were FEV1% predicted, location of care, maintenance oral corticosteroid treatment and body mass index. Treating individuals with severe refractory asthma presents a substantial cost to the health service.

Cost-Efficient Decimal Adder Design in Quantum-dot Cellular Automata

Applications that cannot tolerate the loss of accuracy that results from binary arithmetic demand hardware decimal arithmetic designs. Binary arithmetic in Quantum-dot cellular automata (QCA) technology has been extensively investigated in recent years. However, only limited attention has been paid to QCA decimal arithmetic. In this paper, two cost-efficient binary-coded decimal (BCD) adders are presented. One is based on the carry flow adder (CFA) using a conventional correction method. The other uses the carry look ahead (CLA) algorithm which is the first QCA CLA decimal adder proposed to date. Compared with previous designs, both decimal adders achieve better performance in terms of latency and overall cost. The proposed CFA-based BCD adder has the smallest area with the least number of cells. The proposed CLA-based BCD adder is the fastest with an increase in speed of over 60% when compared with the previous fastest decimal QCA adder. It also has the lowest overall cost with a reduction of over 90% when compared with the previous most cost-efficient design.

Memory Cost Analysis for OpenFlow Multiple Table Lookup

Multiple Table Lookup architectures in Software Defined Networking (SDN) open the door for exciting new network applications. The development of the OpenFlow protocol supported the SDN paradigm. However, the first version of the OpenFlow protocol specified a single table lookup model with the associated constraints in flow entry numbers and search capabilities. With the introduction of multiple table lookup in OpenFlow v1.1, flexible and efficient search to support SDN application innovation became possible. However, implementation of multiple table lookup in hardware to meet high performance requirements is non-trivial. One possible approach involves the use of multi-dimensional lookup algorithms. A high lookup performance can be achieved by using embedded memory for flow entry storage. A detailed study of OpenFlow flow filters for multi-dimensional lookup is presented in this paper. Based on a proposed multiple table lookup architecture, the memory consumption and update performance using parallel single field searches are evaluated. The results demonstrate an efficient multi-table lookup implementation with minimum memory usage.

Sharing services, saving money? Five risks to cost saving when organizations share administrative services

Shared services are a popular reform for governments under financial pressure. The hope is to reduce overheads and increase efficiency by providing support services like HR, finance and procurement once to multiple agencies. Drawing on insights from organization theory and political science, we identify five risks that shared services won’t live up to current expectations. We illustrate each with empirical evidence from the UK, Ireland and further afield, and conclude with suggestions on how to manage these risks.

Executing bag of distributed tasks on the cloud: Investigating the trade-offs between performance and cost

Bag of Distributed Tasks (BoDT) can benefit from decentralised execution on the Cloud. However, there is a trade-off between the performance that can be achieved by employing a large number of Cloud VMs for the tasks and the monetary constraints that are often placed by a user. The research reported in this paper is motivated towards investigating this trade-off so that an optimal plan for deploying BoDT applications on the cloud can be generated. A heuristic algorithm, which considers the user's preference of performance and cost is proposed and implemented. The feasibility of the algorithm is demonstrated by generating execution plans for a sample application. The key result is that the algorithm generates optimal execution plans for the application over 91% of the time.

Willingness to pay for potential enhancements to a low-cost cataract surgical package in rural southern China.

PURPOSE: To assess determinants of patients' willingness to pay (WTP) for potential components of a multi-tiered cataract surgical package offered by a non-governmental organization (NGO) in rural China. DESIGN: Cross-sectional study. METHODS: Demographic and clinical data were collected from 505 patients presenting for cataract screening or surgery in Yangjiang, China. Willingness to pay for potential enhancements to the current surgery package was assessed using a bidding format with random payment cards. RESULTS: Among 426 subjects (84.4%) completing interviews, the mean age was 73.9 ± 7.3 years, 67.6% were women and 73% (n = 310) would pay for at least one offering, with 33-38% WTP for each item. Among those who would pay, the mean WTP for food was US$1.68 ± 0.13, transportation US$3.24 ± 0.25, senior surgeon US$50.0 ± 3.36 and US$89.4 ± 4.19 for an imported intra-ocular lens (IOL). The estimated total recovery from these enhancements under various assumptions would be US$20-50 (compared to the current programme price of US$65). In multivariate models, WTP for the senior surgeon increased with knowledge of a person previously operated for cataract (OR = 2.13, 95% CI 1.42-3.18, p < 0.001). Willingness to pay for the imported IOL increased with knowledge of a previously operated person (OR = 1.85, 95% CI 1.24-2.75, p < 0.01) and decreased with age >75 years (OR = 0.61, 0.40-0.93, p < 0.05). CONCLUSIONS: Opportunities exist to increase cataract programme revenues through multi-tiered offerings in this setting, allowing greater subsidization of low-income patients. Personal familiarity with cataract surgery is important in determining WTP. © 2011 The Authors. Acta Ophthalmologica © 2011 Acta Ophthalmologica Scandinavica Foundation.

A hybrid mixed cost-function TEQ initialization algorithm for ADSL modems

In this paper, we present a hybrid mixed cost-function adaptive initialization algorithm for the time domain equalizer in a discrete multitone (DMT)-based asymmetric digital subscriber loop. Using our approach, a higher convergence rate than that of the commonly used least-mean square algorithm is obtained, whilst attaining bit rates close to the optimum maximum shortening SNR and the upper bound SNR. Moreover, our proposed method outperforms the minimum mean-squared error design for a range of TEQ filter lengths.